11/05/2026
𝐏𝐡𝐏 𝟏,𝟏𝟖𝟓 𝐭𝐨 𝟏,𝟖𝟏𝟎 𝐩𝐞𝐫 𝐜𝐚𝐬𝐞.
That is the hospital cost reduction associated with each 1 percentage-point increase in ERAS® compliance for open stoma closure and open colon resection, according to a new study from the University of the Philippines-Philippine General Hospital
Across 90 elective colorectal cases performed under ERAS® in 2021, the relationship was statistically significant for both procedure types (p=0.0213 and p=0.0134).
Compliance was measured using the ERAS® Interactive Audit System (EIAS). Cost data came from the hospital billing system. Mean compliance across the cohort was 68.21%, close to the 70% benchmark in ERAS® compliance studies.
For minimally invasive procedures, the authors did not find the same pattern. Equipment costs dominate the cost profile in small MIS subgroups, and they flag this for further research rather than drawing a conclusion.
What makes the paper notable is the setting. A government hospital where care is publicly funded. A country where out-of-pocket spending makes up 44.7% of healthcare expenditure.
"𝐻𝑖𝑔ℎ𝑒𝑟 𝐸𝑅𝐴𝑆 𝑐𝑜𝑚𝑝𝑙𝑖𝑎𝑛𝑐𝑒 𝑤𝑎𝑠 𝑎𝑠𝑠𝑜𝑐𝑖𝑎𝑡𝑒𝑑 𝑤𝑖𝑡ℎ 𝑎 𝑑𝑒𝑐𝑟𝑒𝑎𝑠𝑒 𝑖𝑛 ℎ𝑜𝑠𝑝𝑖𝑡𝑎𝑙 𝑒𝑥𝑝𝑒𝑛𝑑𝑖𝑡𝑢𝑟𝑒𝑠 𝑎𝑛𝑑 𝑙𝑒𝑛𝑔𝑡ℎ 𝑜𝑓 𝑠𝑡𝑎𝑦, ℎ𝑖𝑔ℎ𝑙𝑖𝑔ℎ𝑡𝑖𝑛𝑔 𝑡ℎ𝑒 𝑝𝑟𝑜𝑔𝑟𝑎𝑚'𝑠 𝑝𝑜𝑡𝑒𝑛𝑡𝑖𝑎𝑙 𝑓𝑜𝑟 𝑖𝑚𝑝𝑟𝑜𝑣𝑖𝑛𝑔 𝑐𝑜𝑠𝑡-𝑒𝑓𝑓𝑖𝑐𝑖𝑒𝑛𝑐𝑦 𝑖𝑛 𝑟𝑒𝑠𝑜𝑢𝑟𝑐𝑒-𝑙𝑖𝑚𝑖𝑡𝑒𝑑 𝑠𝑒𝑡𝑡𝑖𝑛𝑔𝑠."
The economics of ERAS® have been documented before, mostly in high-income systems. This study adds evidence from a setting where resource allocation is under real pressure, and where better implementation has direct consequences for both hospitals and patients.
Full paper here:
