title: The economic cost of elective carotid endarterectomy.
abstract: Cost awareness and accountability for the use of health care resources have become major issues for clinicians. In order to identify the economic costs associated with carotid endarterectomy (CEA), a retrospective review of 50 elective CEA between May 1993 and April 1994 was undertaken. Despite our belief [based on the Australian National Diagnostic Related Groupings (ANDRG)], that our resource utilization had been refined to produce a median length of stay significantly below the New South Wales (NSW) State average, this study has identified several areas of non-productive expenditure. The mean cost of CEA per patient was $7053. This figure includes non-productive expenditure of $793 per patient in the pre-operative period and $395 per patient in the postoperative period. If these costs, which did not contribute to patient care, were removed the mean cost of CEA would be $5865. The major causes of 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 period.
authors.affiliation: Department of Vascular Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: M I
authors.initials: MI
authors.lastname: Patel
authors.forename: D T
authors.initials: DT
authors.lastname: Hardman
authors.forename: C M
authors.initials: CM
authors.lastname: Fisher
authors.forename: R
authors.initials: R
authors.lastname: Lane
authors.forename: M
authors.initials: M
authors.lastname: Appleberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003365:Costs and Cost Analysis; D004469:Economics, Hospital / Q000458:organization & administration; D017558:Elective Surgical Procedures / Q000191:economics*; D016894:Endarterectomy, Carotid / Q000191:economics*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000191:economics / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000191:economics; D011300:Preoperative Care / Q000191:economics; D011785:Quality Assurance, Health Care / Q000191:economics; D012017:Referral and Consultation; D012189:Retrospective Studies