期刊
MEDICAL CARE
卷 46, 期 12, 页码 1226-1233出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MLR.0b013e31817d9342
关键词
intensive care; critical care; mechanical ventilation; costs; cost-effectiveness
Objectives: To estimate the actual cost savings that could be achieved through reductions in intensive care unit (ICU) length of stay and duration of mechanical ventilation by determining the short-run marginal variable cost of an ICU and ventilator day. Research Design: Retrospective cohort study in a university-affiliated teaching hospital. Subjects: All patients receiving mechanical ventilation in the ICU for more than 48 hours (n = 1778) from July 1, 2005 to June 30, 2006. Measures: The hospital's administrative and cost databases were used to determine total costs. variable costs, and direct-variable costs for each patient oil each individual ICU and hospital day. Results: Direct-variable costs comprised 19.3% of total ICU costs and 18.4% of total hospital costs. Marginal direct-variable costs (the cost of each additional ICU day) were small compared with the average daily total cost ($649 to $839 vs. $1751, in US dollars). In survivors with ICU lengths of stay more than 3 days, the mean direct-variable cost of the last ICU day was $397, while the mean direct-variable cost of the first ward day was $279, for a mean cost difference of $118 (95% CI $21-$190). Reducing ICU and hospital length of stay by I day in all survivors with ICU lengths of stay more than 3 clays would result in an immediate cost savings of only 0.2%, of all hospital expenditures for these patients. Conclusions: Marginal variable ICU costs are relatively small compared with average total costs and are only slightly greater than the cost of a ward day.
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