COST-EFFECTIVE CAROTID ENDARTERECTOMY

BACKGROUND: Carotid endarterectomy is the most common vascular procedu re performed, with an annual cost of $1.2 billion. Efforts to control the cost associated with this procedure include limiting preoperative studies, avoiding admissions to the intensive care unit, and encouragi ng early postoperative discharge. METHODS: To determine our surgical r esults and the cost associated with this procedure, we reviewed our ex perience at a single hospital and compared our cost data with those of other local facilities. RESULTS: During an 18-month period we perform ed 65 carotid endarterectomies at one community hospital. The average per-patient hospital cost was $8,060, which was $3,510 less than the a verage cost at the other facilities in our city. The median length of postoperative stay in our hospital was 1 day. One patient died and the re was 1 postoperative stroke. CONCLUSIONS: Limited utilization of the intensive care unit and short postoperative stays reduced the overall hospital costs. Our 1.5% mortality and stroke rates demonstrate that these cost-saving measures can be implemented without adversely affect ing patient outcome.