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The chronic ventilator-dependent unit: a lower-cost alternative to intensive care
D R Gracey1, D C Hardy, G E Koenig
1Division of Pulmonary and Critical Care Medicine and Internal Medicine, Mayo Clinic Rochester, MN 55905, USA.
Objective:
To evaluate the fixed costs and patient outcomes of a specialty hospital unit for medically stable ventilator-dependent patients. The chronic ventilator-dependent unit (CVDU) was established to facilitate early dismissal from costly intensive care unit (ICU) hospitalization for patients requiring continued specialized care.
Patients And Methods:
We carried out a cost analysis of the various ICUs that transferred patients to the CVDU by year from 1993 through 1998. In addition, direct and indirect costs for the CVDU were established by year for the same period. We then calculated the cost effect of transferring these patients for care from each high-cost ICU to the lower-cost CVDU. Ventilator weaning and mortality rates were also determined.
Results:
During the 6 years of this study, $4,832,551 in patient care costs were saved by transferring care for 964 patients from ICUs to the CVDU. Ventilator weaning was successful in 64% of 549 patients, and mortality was 7% in the same patient group.
Conclusions:
Care in the CVDU yielded lower fixed costs per patient-day, and CVDU care was comparable to ICU hospitalization.