Prehabilitation in Major Surgery: An Evaluation of Cost Savings in a Tertiary Hospital

Background: Prehabilitation programs improve patients' functional capacity before surgery by enhancing physical activity, nutrition, and psychological well-being, thereby reducing postoperative complications, hospital stays, and readmissions. We propose a centralized model led by an advanced practice nurse and internist to minimize consultations and reduce costs. Methods: We studied 211 patients in a tertiary hospital in Madrid, with 135 enrolled in the centralized prehabilitation program and 76 in standard care (control). We compared complications, hospital stays, blood transfusions, and consultations, estimating costs using public pricing from Madrid's healthcare authorities. Results: The centralized model significantly reduced blood transfusions (p=0.014), postoperative complications (p<0.001), and hospital stays (p=0.004), leading to annual savings of €593,453.00. Conclusions: A centralized surgical prehabilitation model decreases complications, hospital stays, readmissions, and consultations compared to standard care, significantly reducing healthcare costs.