COST-EFFECTIVE CAROTID ENDARTERECTOMY

BACKGROUND: Carotid endarterectomy is the most common vascular procedure 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 encouraging early postoperative discharge. METHODS: To determine our surgical results and the cost associated with this procedure, we reviewed our experience at a single hospital and compared our cost data with those of other local facilities. RESULTS: During an 18-month period we performed 65 carotid endarterectomies at one community hospital. The average per-patient hospital cost was $8,060, which was $3,510 less than the average cost at the other facilities in our city. The median length of postoperative stay in our hospital was 1 day. One patient died and there 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 affecting patient outcome.