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.