In this pre-post difference-in-differences study of 15 849 surgical patients at 20 medical centers in Northern California, implementation of a multifaceted enhanced recovery program was associated with a one-third reduction in postoperative complication rates in the target population relative to comparator surgical populations. The program was also associated with decreased hospital mortality among patients undergoing colorectal resection and increased rates of discharge to home among patients undergoing hip fracture repair.

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