Overview
Bariatric surgery is the most effective treatment for severe obesity and its associated diseases. Advances in surgical techniques, enhanced recovery protocols, and multimodal perioperative care have made earlier hospital discharge possible while maintaining patient safety.
This observational cohort study aims to evaluate the economic impact of an early discharge pathway consisting of 24 hours of hospital stay followed by Hospital-at-Home care, compared with the conventional 48-hour hospital stay after bariatric surgery.
The study will compare healthcare costs, resource utilization, clinical safety, organizational efficiency, applicability of the early discharge pathway, and patient satisfaction between both postoperative care models under routine clinical practice.
Description
The implementation of Enhanced Recovery After Surgery (ERAS) protocols, minimally invasive surgical techniques, and optimized multimodal perioperative management has significantly improved postoperative recovery after bariatric surgery, allowing earlier hospital discharge without compromising patient safety.
At Hospital Universitari Parc Taulí, an early discharge pathway combining 24 hours of postoperative hospital stay with structured Hospital-at-Home (HaH) care during the second postoperative day was implemented as part of routine clinical practice in February 2025. This model was developed to optimize healthcare resource utilization while maintaining the same overall duration of postoperative medical supervision as the conventional pathway.
This study is an ambispective comparative observational cohort study designed to evaluate the economic impact of this postoperative care pathway under real-world clinical conditions. Patients managed with the conventional 48-hour hospital stay before implementation of the protocol will be compared with patients managed using the early discharge plus Hospital-at-Home pathway after implementation.
The study will evaluate direct healthcare costs, healthcare resource utilization, clinical safety, organizational efficiency, applicability of the early discharge pathway, and patient satisfaction. The results are expected to provide evidence regarding the economic and organizational impact of Hospital-at-Home as an alternative postoperative care model following bariatric surgery within a public healthcare system.
Eligibility
Inclusion Criteria:
- Age 18 years or older.
- Patients undergoing elective bariatric surgery.
- Bariatric surgery performed during the predefined study periods for either cohort.
- Availability of sufficient clinical and economic data for study analysis.
Exclusion Criteria:
- Emergency surgery.
- Intraoperative complications requiring postoperative management outside the standard care pathway.
- Unplanned admission to an intensive care unit.
- Incomplete clinical or economic data preventing study analysis.
