title: Institutional economic losses associated with AAA repair are independent of technique.
abstract: OBJECTIVE
  To investigate the perception of significant economic loss associated with endovascular abdominal aortic aneurysm (AAA) repair by comparing economic variables for the open and endovascular techniques.
  
  
  METHODS
  In a 1-year period, 20 consecutive patients (19 men; mean age 73.3 years, range 62-89) were treated for uncomplicated infrarenal AAAs using conventional open repair in 11 and endovascular repair (EVR) in 9. For the open repair, standard techniques were employed, including transperitoneal and retroperitoneal exposures; in EVR, both the AneuRx and Ancure systems were utilized. Length of stay and institutional costs were carefully tracked and compared.
  
  
  RESULTS
  The patients were similar with regard to comorbidities, but the endograft patients were older (p=0.02) Length of stay was significantly lower in the EVR group (1.9 +/- 0.9 days) compared with the open group (8.4 +/- 4.5 days, p=0.0004). However, total mean treatment costs (open: $17,576 +/- $11,025 and EVR: $20,247 +/- $5003; p=0.51) and subsequent losses (open: -$3949 +/- $7095 and EVR: -$7572 +/- $4488; p=0.20) were not significantly different between the groups. CONCLUSIONS; The costs associated with the care of AAA patients are independent of the technique used for repair. The economic loss associated with treatment is directly related to inadequate reimbursement on the part of Medicare and other carriers.
authors.affiliation: Tucson Vascular Surgery, Suite 145, 1701 W. St. Mary's Road, Tucson, AZ 85745, USA. sberman@azvasc.com
authors.forename: Scott S
authors.initials: SS
authors.lastname: Berman
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Gentile
authors.forename: Eric S
authors.initials: ES
authors.lastname: Berens
authors.forename: Jan
authors.initials: J
authors.lastname: Haskell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000191:economics* / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000191:economics; D003365:Costs and Cost Analysis; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007349:Insurance, Health, Reimbursement; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015607:Stents / Q000191:economics; D014656:Vascular Surgical Procedures / Q000191:economics / Q000379:methods