THE ECONOMIC COST OF ELECTIVE CAROTID ENDARTERECTOMY

Cost awareness and accountability for the use of health care resources have become major issues for clinicians. In order to identify the eco nomic costs associated with carotid endarterectomy (CEA), a retrospect ive review of 50 elective CEA between May 1993 and April 1994 was unde rtaken. Despite our belief [based on the Australian National Diagnosti c Related Groupings (ANDRG)], that our resource utilization had been r efined to produce a median length of stay significantly below the New South Wales (NSW) State average, this study has identified several are as of non-productive expenditure. The mean cost of CEA per patient was $7053. This figure includes non-productive expenditure of $793 per pa tient in the pre-operative period and $395 per patient in the postoper ative period. If these costs, which did not contribute to patient care , were removed the mean cost of CEA would be $5865. The major causes o f non-productive resource utilization included prolonged pre-operative stay, duplicated or omitted investigations, as well as the use of the Intensive Care Unit for patient monitoring in the postoperative perio d.