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Erschienen in:
10.01.2022 | PREHABILITATION (B RIEDEL AND S JACK, SECTION EDITORS)
Is the Integration of Prehabilitation into Routine Clinical Practice Financially Viable? A Financial Projection Analysis
Erschienen in: Current Anesthesiology Reports | Ausgabe 1/2022
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Purpose of Review
A growing body of evidence supports the use of prehabilitation to reduce the incidence and severity of surgical complications. However, the economic viability of prehabilitation must be evaluated and confirmed prior to its clinical integration as a routine perioperative health service. This article extends previous research-based economic analyses with financial projections of the costs, cost-savings, and cost-benefit of clinical prehabilitation. To accomplish this, we used (i) projected prehabilitation program costs; (ii) surgical morbidity rates based on data from the American College of Surgeons, National Surgical Quality Improvement Program (NSQIP); (iii) the median cost of surgical morbidity; and (iv) the projected reduction in surgical morbidity by prehabilitation.
Recent Findings
Using the best available evidence for our calculation parameters, we project a net positive cost-benefit of clinically integrating prehabilitation attributed to reduced costs associated with surgical morbidity. We present several sensitivity analyses to account for the variability and uncertainty of surgical morbidity rates and costs of surgical morbidity. Evaluating a profits and losses analysis highlights the incremental return on investment proportional to annual patient volume, underscoring the importance of healthcare system engagement to attain timely referrals and ultimately the viability of clinically integrated prehabilitation.
Summary
We forecasted a net positive cost-benefit attributed to surgical morbidity cost-savings using the best available evidence of our calculation parameters. However, annual cost-benefit can be expected to fluctuate due to varying institutional surgical morbidity rates, the efficacy of prehabilitation programming, and costs of surgical morbidity. Although this financial projection analysis provides novel economic insight into the financial viability of clinically integrated prehabilitation, future work establishing cost-benefit and cost-effectiveness of prehabilitation grounded in formal program evaluations is necessary to definitively support the integration of prehabilitation as a standard of care in clinical practice.
