title: A systematic review to assess cost effectiveness of enhanced recovery after surgery programmes in colorectal surgery.
abstract: OBJECTIVE
  Enhanced recovery after surgery (ERAS) programmes have been shown to reduce length of stay and peri-operative morbidity. However, there are comparatively few data on their cost effectiveness. The object of this systematic review was to appraise the current literature to determine the cost effectiveness of ERAS and to characterize how cost is reported and evaluated.
  
  
  METHODS
  An electronic database search identified studies comparing ERAS with standard peri-operative care in colorectal surgery where an evaluation of cost effectiveness was a primary or secondary outcome. Cost data were converted to euros to enable a more standardized comparison of the studies. There were no limits on study design.
  
  
  RESULTS
  Seven articles were included in the analysis. The reporting and evaluation of cost data were inconsistent. Reported cost for ERAS ranged from €1989 to €12,805 per patient. Although not all statistically significant, all studies demonstrated cost reductions with ERAS compared with non-ERAS although they were highly variable, ranging from €153 to €6537 per patient.
  
  
  CONCLUSIONS
  Although the review has shown ERAS to be cost effective, there are some important inconsistencies and deficiencies regarding the reporting of data. Authors should therefore be encouraged to report cost data to supplement the literature detailing clinical efficacy.
authors.affiliation: Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand.
authors.forename: D P
authors.initials: DP
authors.lastname: Lemanu
authors.forename: P P
authors.initials: PP
authors.lastname: Singh
authors.forename: M D J
authors.initials: MD
authors.lastname: Stowers
authors.forename: A G
authors.initials: AG
authors.lastname: Hill
mesh_terms: D003106:Colon / Q000601:surgery*; D003362:Cost-Benefit Analysis; D006801:Humans; D007902:Length of Stay / Q000191:economics; D010359:Patient Readmission / Q000191:economics; D011182:Postoperative Care / Q000191:economics* / Q000379:methods*; D012007:Rectum / Q000601:surgery*; D012086:Reoperation / Q000191:economics
keywords: ERAS; colorectal; cost effectiveness; enhanced recovery after surgery; perioperative care