title: An all-inclusive and transparent view of a vascular program's direct impact on its health system.
abstract: OBJECTIVE
  This study explores the fiduciary advantage of a Vascular Surgery program to an academic, tertiary care hospital.
  
  
  METHODS
  This is a retrospective review of hospital (HealthQuest) and physician (IDX) billing databases from April 2009 to September 2010. We identified all patients interacting with Vascular Surgery (VS) to provide an overview of global finances. Patients introduced solely by VS were identified to minimize confounding of the downstream effect. Outcome measures obtained were revenue, average and total gross margin, relative value unit production, and service utilization.
  
  
  RESULTS
  A total of 552 cases were identified demonstrating $13 million in revenue. This translated into a gross margin of $5 million. Examined per surgeon, VS was the most profitable, producing $1.6 million. Lower extremity amputation had the highest average gross margin at $34,000. Notably, $8 million in direct cost is among the highest in the health system. A total of 137 cases unique to VS generated $5 million in total revenue. This patient subset made use of up to 29 physician specialty services. General Medicine and Radiology were the most frequently utilized.
  
  
  CONCLUSIONS
  The overall profitability of a comprehensive vascular program is tremendously positive. This study verifies that new vascular-specific referrals are a significant catalyst for revenue.
authors.affiliation: Division of Vascular Surgery, Cooper University Hospital, Camden, NJ, USA.
authors.forename: Nyali
authors.initials: N
authors.lastname: Taylor
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Lombardi
authors.forename: Sandra
authors.initials: S
authors.lastname: Toddes
authors.forename: James
authors.initials: J
authors.lastname: Alexander
authors.forename: Jose
authors.initials: J
authors.lastname: Trani
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Carpenter
mesh_terms: D000046:Academic Medical Centers / Q000191:economics* / Q000458:organization & administration; D003362:Cost-Benefit Analysis; D019992:Databases as Topic; D019033:Delivery of Health Care, Integrated / Q000191:economics* / Q000458:organization & administration / Q000706:statistics & numerical data; D004526:Efficiency; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D017721:Hospital Costs; D006801:Humans; D007373:Interinstitutional Relations; D009515:New Jersey; D011216:Practice Management, Medical / Q000191:economics* / Q000458:organization & administration; D015397:Program Evaluation; D012017:Referral and Consultation / Q000191:economics* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures / Q000191:economics* / Q000458:organization & administration / Q000706:statistics & numerical data; D016526:Workload