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The relationship between labour cost per patient and the size of intensive care units: a multicentre prospective study

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Abstract

Objective

We examined the relationship between major ICU characteristics and labour cost per patient.

Design

Four-week prospective data collection, in which the hours spent by each physician and nurse on both in-ICU and extra-ICU activities were collected.

Setting

Eighty Italian adult ICUs.

Measurements and results

The cost of the time actually spent by ICU staff on ICU patients (labour cost) was computed for each participating unit, by applying to the average annual salaries the proportions of in-ICU activity working time for physicians and nurses. Multiple regression analysis was used to identify ICU characteristics that predict labour costs per patient. Labour cost per patient was positively correlated with ICU mortality and patients average length of stay (slopes =0.67, p =0.048 and 0.09, p <0.0001, respectively). Labour cost per patient decreases almost linearly as the number of beds increases up to about eight, and it remains nearly constant above about twelve beds. The number of patients admitted per physician (not per nurse) increases with the number of beds (Spearman correlation coefficient =0.567, p <0.0001).

Conclusions

Our findings suggest that ICUs with less than about 12 beds are not cost-effective.

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References

  1. Jacobs P, Noseworthy TW (1990) National estimates of intensive care utilization and costs: Canada and the United States. Crit Care Med 18:1282–1286

    Article  CAS  Google Scholar 

  2. Glydmark M (1995) A review of cost studies of intensive care units: problems with the cost concepts. Crit Care Med 23:964–972

    Article  Google Scholar 

  3. Edbrooke DL, Hibbert CL, Ridley S, Long T, Dickie H (1999) The development of a method for comparative costing of individual intensive care units. Anaesthesia 54:110–120

    Article  CAS  Google Scholar 

  4. Miranda DR, Ryan DW, Schaufeli WB, Fidler V (Eds.) (1998) Organization and management of intensive care: a prospective study in 12 European Countries. Springer, Berlin Heidelberg New York

    Google Scholar 

  5. Brazzi L, Bertolini G, Arrighi E, Rossi F, Facchini R, Luciani D (2002) Top-down costing: problems in determining staff costs in intensive care medicine. Intensive Care Med 28:1661–1663

    Article  Google Scholar 

  6. Kleinbaum DG, Kupper LL, Muller KE (1988) Applied regression analysis and other multivariable methods. Brooks/Cole, Pacific Grove, Calif., USA

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Acknowledgements

We are indebted to Marta Cattaneo for her invaluable help. The study was partially supported by a grant from Ricerca Finalizzata, Ministero della Sanità, Contratto N° ICS-030.2RF95/199 “La valutazione delle prestazioni e dei costi delle Terapie Intensive nell’ambito del nuovo sistema di finanziamento ospedaliero” and by an unconditioned grant from AstraZeneca Italia S.p.A., Milano, Italy.

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Authors and Affiliations

  1. GiViTI Coordinating Center, Istituto di Ricerche Farmacologiche “Mario Negri”, Centro di Ricerche Cliniche per le Malattie Rare Aldo e Cele Daccò, 24020 , Ranica , (Bergamo), Italy

    Guido Bertolini & Carlotta Rossi

  2. Istituto di Anestesia e Rianimazione, Ospedale Maggiore Policlinico IRCCS, Milan, Italy

    Luca Brazzi

  3. I Servizio di Anestesia e Rianimazione, Ospedale Civile di Legnano, Legnano , (Milan), Italy

    Danilo Radrizzani

  4. I Servizio di Anestesia e Rianimazione, Spedali Riuniti, Livorno, Italy

    Giancarlo Rossi

  5. Istituto di Economia Sanitaria, Milan, Italy

    Enrico Arrighi

  6. Servizio di Anestesia e Rianimazione, Ospedale Generale Provinciale, Lucca, Italy

    Bruno Simini

Authors
  1. Guido Bertolini
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  2. Carlotta Rossi
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  3. Luca Brazzi
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  4. Danilo Radrizzani
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  5. Giancarlo Rossi
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  6. Enrico Arrighi
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  7. Bruno Simini
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Corresponding author

Correspondence to Guido Bertolini.

Additional information

The authors appear on behalf of the GiViTI group [Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva (Italian Group for the Evaluation of Interventions in Intensive Care Medicine)]. A complete list of study participants appears in the Appendix

Appendix

Appendix

List of participating clinicians (with their hospitals in brackets): Guagliardi Clementina (Acquaviva delle Fonti-BA); Prigione Bonifacio (Alessandria); Gallini Carla (Alessandria); Pennacchioni Silvio (Ancona); Vernero Sandra (Aosta); Nannoni Sonia (Arezzo); Gavioso Marina (Asti); Cinnella Gilda (Bari); Pegoraro Maurizio (Bassano del Grappa-VI); Pezza Brunello (Benevento); Ricci Alessandro (Bologna); Neri Massimo (Bologna); Giovannitti Alfonso (Bologna); Sangiorgi Gabriela (Bologna); Baroncini Simonetta (Bologna); Zappa Sergio (Brescia); Cabano Gianni (Busto Arsizio-VA); Pastorini Simonetta (Camposampiero-PD); Gabriele Franco (Castellana Grotte-BA); Quattrocchi Pasqualino (Catania); Visconti Maria Grazia (Cernusco S/N-MI); Mancinelli Annetta (Chieti); Camerini Sandro (Cremona); Alberti Arnaldo (Dolo-VE); Giannoni Stefano (Empoli); Maitan Stefano (Faenza-RA); Mantovani Giorgio (Ferrara); Bartoli Teresa (Firenze); Mangani Valerio (Firenze); Rossi Gianni (Imola-BO); Di Lullo Giuliana (Isernia); Cossu Giovanni (La Spezia); Carinci Pier Paolo (Lanciano-CH); Caione Raffaele (Lecce); Ciceri Rita (Lecco); Tavola Mario (Lecco); Cirillo Francesco Maria (Legnago-VR); Cortellazzi Paolo (Legnano-MI); Rossi Giancarlo (Livorno); Paternesi Nazareno (Macerata); Guadagnucci Alberto (Massa); Sicignano Alberto (Milano); Rotelli Stefano (Milano); Boselli Luigi (Milano); Ravizza Adriano (Milano); Pezzi Angelo (Milano); Giudici Daniela (Milano); Beretta Luigi (Milano); Azzimonti Gaetano (Milano); Salmoiraghi Luisa (Milano); Marcora Barbara (Monza-MI); Postiglione Maurizio (Napoli); Zuccoli Paolo (Parma); Spadini Elisabetta (Parma); Negri Giovanni (Pavia); Carnevale Livio (Pavia); Gorietti Adonella (Perugia); Breschi Cesare (Pesaro); Dagnino Alessandro (Pietra Ligure-SV); Lagomarsini Ginetta (Pisa); Malacarne Paolo (Pisa); Lavacchi Luca (Pistoia); Garelli Alberto (Ravenna); Bottari Walter (Reggio Emilia); Pessina Carla (Rho-MI); Barberis Bruno (Rivoli-TO); Manni Corrado (Roma); Appierto Linda (Roma); Siviero Silvano (Rovigo); Hellmann Ferruccio (Savigliano-CN); Vecchietti Massimo (Savona); Rosi Roberto (Siena); Nucifora Concetto (Siracusa); Scherini Alberto (Sondrio); Vaj Monica (Torino); Nascimben Ennio (Treviso); Cominotti Silvano (Varese); Zamponi Edoardo (Vercelli); Digito Antonio (Vicenza); Muttini Stefano (Vimercate)

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Bertolini, G., Rossi, C., Brazzi, L. et al. The relationship between labour cost per patient and the size of intensive care units: a multicentre prospective study. Intensive Care Med 29, 2307–2311 (2003). https://doi.org/10.1007/s00134-003-2019-1

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  • DOI: https://doi.org/10.1007/s00134-003-2019-1

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