A Statistically Significant Reduction in Length of Stay and Hospital Costs with Equivalent Quality of Care Metrics for E
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ORIGINAL ARTICLE
A Statistically Significant Reduction in Length of Stay and Hospital Costs with Equivalent Quality of Care Metrics for ERCPs Performed During the Weekend Versus Postponed to Weekdays: A 6‑Year Study of 533 ERCPs at Four Teaching Hospitals Seifeldin Hakim1 · Andrew M. Aneese1 · Ahmed Edhi1 · Christienne Shams1 · Treta Purohit1,2 · Michael E. Cannon3,4 · Mitchell S. Cappell1,4 Received: 16 June 2019 / Accepted: 9 January 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic/therapeutic endoscopic procedure for numerous pancreaticobiliary diseases. Data regarding performing ERCP on weekend (WE; Saturday/Sunday) versus postponing ERCP to first two available weekdays (WD; Monday/Tuesday) are scarce. ERCP requires costly resources including specialized nurses, endoscopy room equipped with fluoroscopy, anesthesia services, and highly trained therapeutic endoscopists. Hospitals frequently do not have these resources readily available during WE, leading to postponing ERCPs to WD. Aims This study analyzes the effect of performing ERCP on WE versus postponement to WD on hospital efficiency, and on patient safety/outcomes. Methods A computerized search of electronic medical records, January 2011–December 2016, at four Beaumont Hospitals retrospectively identified all gastroenterology consults performed on Friday or Saturday before 12:00 noon, which resulted in ERCP performed for any indication on WE versus postponing ERCP to WD. Length of stay (LOS), hospital costs, hospital charges, and hospital reimbursements were compared between both groups, as were quality of care measures. Results Among 5196 patients undergoing ERCPs, 533 patients were identified, including 315 patients in the WE group and 218 patients in the WD group. Comparing WE versus WD groups, median LOS was shorter (4.5 days vs. 6.9 days, p
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