基于蒙特卡洛模拟验证的骨科日间手术ERAS模式的成本效益分析

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中图分类号：R197.323;R68 文献标识码：A

CostEffctiveness Analysis ofthe ERAS Model inOrthopedic DaySurgery Basedonthe ValidationofMonte Carlo Simulation/CHEN Gejun，DAI Chuanqiang，ZHOU Hongyu，et al.//Chinese Health Quality Management，2025，32（10） ：41一45，55

Abstract ObjectiveTo evaluate the application efectiveness and health economic benefits of the Enhanced Recovery After Surgery （ERAS） model inorthopedic day surgery，and to verify the robustnessof the economic outcomes using Monte Carlo simulation.MethodsA retrospective cohort study was conducted using medical record data from January 2022 to August 2024.Patients who did notundergo the ERAS model beforeJanuary 2023 were included in the control group，while those who underwent the ERAS model after January 2O23 were included in the observation group for comparative analysis.ResultsPatients in the observation group demonstrated superior outcomes compared to the control group in terms of the Richmond Agitation-Sedation Scale （RASS）scores，incidence of postoperative agitation and adverse reactions，with statistically significant differences （ P<0.05 ）. Additionally，the observation group exhibited beter postoperative pain scores，complication scores，patientsatisfaction，and treatment eficacy，with statistically significant differences （ P<0.05 ）. Health economic indicators revealed that patients in the observation group had lower hospitalization costs anda more favorablecost一efectivenessratio compared tothecontrol group，with statistically significant differences（ P<0.05 ）. The advantages of the ERAS model in terms of cost一effectiveness were further validated by Monte Carlo simulation results.ConclusionThe application of the ERAS modelinorthopedic day surgery significantlyaccelerates postoperativerecovery，reduces theincidenceof postoperativeadversereactions，andofers advantages inimproving health economic indicators.Monte Carlo simulation provides evidence supporting the evaluation of the economic effectiveness of the ERAS model.

Keywords Enhanced Recovery After Surgery; Orthopedics; Day Surgery; Cost-Effctiveness; Monte Carlo Simulation First-author'saddress Ziyang Central Hospital，Ziyang，Sichuan，64l3oo，China

加速康复外科（enhancedrecover-yaftersurgery，ERAS）是一种基于循证医学的综合性管理策略，其核心在于通过多学科团队的紧密协作，优化并整合围手术期各项管理措施，减少手术应激反应，促进器官功能快速恢《中国卫生质量管理》第32卷第10期（总第215期）2025年10月复，缩短住院时间，并降低术后并发症发生率及再入院率[1]。（剩余7548字）