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Critical Care

, 12:R68

First Online: 15 May 2008Received: 28 September 2007Revised: 07 April 2008Accepted: 15 May 2008

Abstract

IntroductionThe high cost of critical care resources has resulted in strategies to reduce the costs of ruling out low-risk patients by developing intermediate care units IMCs. The aim of this study was to compare changes in total hospital costs for intensive care patients before and after the introduction of an IMC at the University Hospital Maastricht.

MethodsThe design was a comparative longitudinal study. The setting was a university hospital with a mixed intensive care unit ICU, an IMC, and general wards. Changes in total hospital costs were measured for patients who were admitted to the ICU before and after the introduction of the IMC. The comparison of interest was the opening of a six-bed mixed IMC.

ResultsThe mean total hospital cost per patient increased significantly. Before the introduction of the IMC, the total hospital cost per patient was €12,961 ± €14,530 and afterwards it rose to €16,513 ± €17,718. Multiple regression analysis was used to determine to what extent patient characteristics explained these higher hospital costs using mortality, type of stay, diagnostic categories, length of ICU and ward stay, and the Therapeutic Intervention Scoring System TISS as predictors. More surgical patients, greater requirements of therapeutic interventions on the ICU admission day, and longer ICU stay in patients did explain the increase in hospital costs, rather than the introduction of the IMC.

ConclusionAfter the introduction of the IMC, the higher mean total hospital costs for patients with a high TISS score and longer ICU stay explained the cost increase.

AbbreviationsAPACHE IIAcute Physiology and Chronic Health Evaluation II

ICUintensive care unit

IMCintermediate care unit

LOSlength of stay

TISS-28Therapeutic Intervention Scoring System

TISS-28 1st dayfirst Therapeutic Intervention Scoring System score 24 hours after admission.

Electronic supplementary materialThe online version of this article doi:10.1186-cc6903 contains supplementary material, which is available to authorized users.

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Author: Barbara CJ Solberg - Carmen D Dirksen - Fred HM Nieman - Godefridus van Merode - Martijn Poeze - Graham Ramsay

Source: https://link.springer.com/



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