OBJECTIVES: French HTA has set the goal of achieving 70% of outpatient surgical procedures by 2022, but a slowdown has been observed in recent years due to the existence of barriers linked to the risk of postoperative complications which concerns 10 to 15% of patients.^1,2 It hinders the deployment of Enhanced Recovery After Surgery (ERAS) protocols, which remain sparsely used in France.

Remote monitoring medical devices (RMMD) can remove these barriers by facilitating and securing the early discharge of patients at risk of post-surgical complications.

The objective of this study is to describe the characteristics of post-surgical hospital care in France by major diagnostic categories.

METHODS: This is a retrospective transversal study based on French national claims hospitals database (PMSI), covering all public and private care centers in France.

Patients ≥ 18 years old who had at least one hospitalization for surgery in one of the three major diagnostic categories (MDC) (respiratory (RS), digestive (DS), and endocrine, nutritional, and metabolic (ENM)) in 2019 were included in the study.

The length of hospitalization (LH) and hospitalization severity (HS) were described by MDC separately.

RESULTS: For the three MDC, we identified 172,243 hospitalizations (RS: 33,614 (20%), DS: 101,714 (59%), ENM: 36,915 (21%)) including 8%, 8% and 16% of hospitalizations with ERAS protocol, respectively.

The LH was shorter with ERAS vs non-ERAS, -3.5 days for RS, -4.1 days for DS and -1.2 days for ENM and severe HS was less present in ERAS hospitalizations independent of MDC (14.2% vs 25% for RS, 33.8% vs 49.4% for DS, 1.3% vs 2.6% ENM).

CONCLUSIONS: This study provided a national understanding of the post-surgical practices in particular the LH reduction linked to ERAS and associated patient’s severity.

The observed size effect is a relevant input for clinical investigation design to assess the clinical and economic benefits of RMMDs.