Abstract
A prospective analysis of the cost of intensive care was carried out on 67 admissions to a multidisciplinary ICU. Admissions were grouped and investigated according to various criteria such as admitting diagnosis, admission status (elective vs emergency), severity of illness and outcome. Total ICU admission costs, total per diem ICU costs and per diem costs divided into fixed and variable cost items for the patient groups are reported. Lower total and per diem ICU charges were observed for elective surgical patients, patients with lower severity of illness as assessed by the Therapeutic Intervention Scoring system and survivors. Emergency admissions were more expensive than elective admissions when compared for total ICU admission costs. Length of stay was a significant factor in overall ICU costs. Within the variable cost items, the diagnostic laboratory was the single most costly item per day. As a result of this analysis, the authors propose several suggestions for reducing ICU costs independent of case-mix or diagnosis-related groupings of ICU patients.
Résumé
Une analyse prospective des coûts des soins intensifs est faite sur 67 admissions à l’unité multidisciplinaire des soins intensifs. Les admissions étaient groupées et investiguées selon des critères variés tels que le diagnostic d’admission, l’état à l’admission (électif vs urgence), la sévérité de la maladie et le résultat final. Le coût total de l’admission, le coût total per diem aux soins intensifs et le coût per diem séparé en coût des items fixes et variables pour les groupes de patients est rapporté. Des coûts plus bas, totaux et per diem ont été notés pour des patients chirurgicaux admis électivement, des patients présentant des maladies moins sévères telles qu’ évaluées par le système du“Therapeutic Intervention Scoring System and Survivors”. Les admissions d’urgence étaient plus coûteuses que les admissions électives quand on compare le coût total de l’admission aux soins intensifs. La durée du séjour était un facteur significatif dans le coût total des soins intensifs. Dans les items variables, le coût des tests diagnostiques de laboratoire était l’item le plus coûteux par jour. Comme résultat de cette anlyse les auteurs proposent plusieurs suggestions pour réduire le coût des soins intensifs indépendamment de la présence des cas mixtes ou du groupement des patients en fonction du diagnostic.
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Girotti, M.J., Brown, S.J.L. Reducing the costs of ICU admission in Canada without diagnosis-related or case-mix groupings. Can Anaesth Soc J 33, 765–772 (1986). https://doi.org/10.1007/BF03027128
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DOI: https://doi.org/10.1007/BF03027128