Socioeconomic concerns in vascular surgery

Surgical hospital payment issues and socioeconomic concerns are likely to attract more attention in the future, especially regarding access and the quality of surgical care. We analyzed all peripheral vascular surgical admissions ( n = 1240) by age treated at the Long Island Jewish Medical Center from 1985 to 1987. Hospital cost and length of stay per patient increased with age, as did losses under diagnostic related group (DRG) prospective hospital payment. Hospital cost by hospital service showed considerable variation by age category; outliers, mortality, and the number of diagnoses and procedures generally rose with age. Use of hospital resources, such as emergency or surgical intensive care unit admission, or the need for blood or plasma products was high in general for patients undergoing peripheral vascular surgery. This study demonstrates a number of findings regarding the socioeconomic factors for hospitalized patients undergoing peripheral vascular surgery. Surgical health policy analysis of this specialty vis-a-vis current changes proposed to the federal medicare DRG system in the U.S. Congress and Health Care Financing Administration suggests a relatively greater impact on the specialty of peripheral vascular surgery demonstrated in this study by the use of higher resources of the same. ( J Vasc Surg 1989;9:479–86.)