An inexpensive programme to help surgery patients get physically and mentally ready for their upcoming operation may help reduce overall costs and get them home faster, according to new research involving hundreds of patients in 21 hospitals across Michigan.
“Prehabilitation,” as it’s called, uses the weeks before surgery to encourage patients to move more, eat healthier, cut back on tobacco, breathe deeper, reduce their stress and focus on their goals for after their operation.
In 2017, after its first test in surgery patients at the University of Michigan, the approach showed signs of reducing total medical costs related to the patient’s care, and cutting their length of stay in the hospital, compared with similar Michigan Medicine patients who had surgery before the program began.
The new study confirms those results on a statewide and more rigorous scale. Published in the Journal of the American College of Surgeons, it’s based on data from 523 patients with traditional Medicare coverage who went through “prehab,” and more than 1,000 similar patients who did not.
It finds that prehab patients across the state left the hospital one day earlier, and were more likely to go straight home rather than to a skilled nursing facility, compared with similar patients treated at the same hospital. Total costs for all care up to three months after surgery were nearly $3,200 less on average for those who went through prehab.
Meanwhile, in a second new paper published in Annals of Surgery, the researchers propose that surgical teams adopt the same “positive psychology” approach to engaging with surgery candidates that patients in the study were taught.
“Every time the prehab study has been studied, it’s found to increase the value of surgical care by improving care while reducing cost. This study cements the business case for hospitals to support it,” says Michael Englesbe, who leads the UM Department of Surgery team that has published both studies and others.
“We also now recognise that prehab’s physical training may work partly because it empowers the patient to engage in their own recovery,” adds Englesbe, a professor of surgery and director of the Michigan Surgical Quality Collaborative. “Patient empowerment is the ‘secret sauce’ and we hope to harness it even