Articles: intensive-care-units.
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Critical care medicine · May 1995
Comparative StudyDo elderly patients overutilize healthcare resources and benefit less from them than younger patients? A study of patients who underwent craniotomy for treatment of neoplasm.
Some physicians and academicians have suggested that limiting selected healthcare resources to the elderly will help curtail the rising cost of health care in the United States. In order to test this hypothesis in a specific medical context, we compared the cost of caring for younger (< 65 yrs) patients with that of caring for older (> or = 65 yrs) patients who underwent craniotomy for treatment of brain tumors. ⋯ The assertion that the elderly may, under certain conditions, consume more healthcare resources and benefit less from them than younger patients must be tested for accuracy with regard to specific disease states. In the context of the disorder studied herein, the elderly do as well as the young. Without specific study of specific pathologic processes or surgical procedures, using age to limit access to resources remains an unsubstantiated, ideologic concept, rather than a scientifically proven cost-saving measure.
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Comparative Study Clinical Trial
Short-stay carotid endarterectomy is safe and cost-effective.
Carotid endarterectomy (CEA) is conventionally performed following a contrast arteriogram, under general anesthesia, and with postoperative admission to an intensive care unit (ICU). We investigated whether any of these traditional adjuncts to CEA is necessary. ⋯ This pilot study suggests that CEA can be safely performed without routine preoperative carotid arteriography; that routine ICU admission is unnecessary for the majority of cases; and that elimination of routine arteriography and ICU admission can reduce hospital charges for CEA by nearly one half.