Cost analysis of carotid endarterectomy: Is age a factor?

Amir H. Dorafshar, Todd D. Reil, Wesley S. Moore, William J. Quinones-Baldrich, Niren Angle, Fariba Fahoomand, Samuel S. Ahn, Hugh A. Gelabert, J. Dennis Baker, Julie A. Freischlag

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Carotid endarterectomy (CEA) has been demonstrated to be safe and effective in elderly patients. Our aim was to analyze and compare outcome and cost of CEA in both elderly and younger patient groups. A total of 125 consecutive patients who underwent CEA were examined retrospectively and grouped according to age (<80 years old, n = 95; and ≥80 years old, n = 30). The actual total costs and itemized costs were analyzed, and diagnosis-related group (DRG) code payor mix were identified. Patient demographics and risk factors were similar except for a greater incidence of coronary artery disease (CAD) in the ≥80 group than in these <80 (43.3% vs. 21.1%, p < 0.05). Patients had similar minor complication rates; however, the ≥80 group had higher perioperative major complications (16.7% vs. 1.1%, p < 0.01). There were no deaths and there was one perioperative stroke, which occurred in the <80 group. Mean length of stay (LOS), intensive care unit (ICU) LOS, and ICU admissions were greater in the ≥80 group. Cost figures were normalized to a base value of $100 to maintain proprietary data. Actual total costs of CEA were $131.50 for the ≥80 group and $100 for the <80 group (p < 0.001). Significant cost differences were found in ICU room costs, and costs for clinical laboratory, radiology imaging, other specialty consults, operating room, and ancillary services in the ≥80 group compared with the <80 group. These results show that the cost of CEA in the elderly is significantly greater than that for younger patients. This difference can be attributed to a greater number of major complications in the more elderly group, who require increased ICU stay, and thus require more clinical laboratory, radiology imaging, and specialty consult service resources. Consideration should be given for a DRG modifier code to increase hospital reimbursement for increased associated costs in elderly patients undergoing CEA.

Original languageEnglish (US)
Pages (from-to)729-735
Number of pages7
JournalAnnals of Vascular Surgery
Volume18
Issue number6
DOIs
StatePublished - Nov 2004
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Cost analysis of carotid endarterectomy: Is age a factor?'. Together they form a unique fingerprint.

  • Cite this

    Dorafshar, A. H., Reil, T. D., Moore, W. S., Quinones-Baldrich, W. J., Angle, N., Fahoomand, F., Ahn, S. S., Gelabert, H. A., Baker, J. D., & Freischlag, J. A. (2004). Cost analysis of carotid endarterectomy: Is age a factor? Annals of Vascular Surgery, 18(6), 729-735. https://doi.org/10.1007/s10016-004-0107-5