Health care resources consumed to treat postoperative infections: Cost saving by perioperative immunonutrition

The objectives of the study were to calculate the costs of postoperative co mplications and to evaluate whether the use of perioperative enteral immuno nutrition, may lead to a saving in health care resources consumed. The econ omic analysis was based on data from a randomized double-blind trial that i nclude 206 cancer patients who received perioperatively either enteral immu nonutrition (treatment group, n = 102) or a standard enteral diet (control group, n = 104), Estimates of costs were based on resource use for treatmen t of complications, which were valued according to the National List of San itary Costs of the Italian Ministry of Health and on the medical Diagnosis- Related-Group (DRG) reimbursement rates. Costs of nutrition were also calcu lated. Cost comparison and cost effectiveness analyses were then carried ou t. Intent-to-treat analysis showed that the total costs of 52 postoperative complications were 322,218 euros, with a consumption of the DRG reimbursem ent rate of 15.4%. The costs of nutrition were 35,437 euros in the treatmen t group versus 10,768 euros in the control group. The total costs (nutritio n plus treating complications) amounted to 113,778 euros in the treatment g roup versus 254,450 euros in the control group. The mean total costs per pa tient were 1,115 euros in the treatment group versus 2,447 euros in the con trol group (P = 0.04). Effectiveness was 83.3% in the treatment group versu s 68.3% in the control group (P = 0.009), Cost effectiveness analysis showe d a net saving of 2,386 euros per complication-free patient in favor of the treatment group. In conclusion, the perioperative use of immunonutrition a ppears cost effective due to a substantial saving of resources used to trea t postoperative complications.