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Related Experiment Videos

Development of a continuous renal replacement program in critically ill patients.

Roger W Gilbert1, Daniel M Caruso, Kevin N Foster

  • 1Maricopa Medical Center, Arizona Burn Center, 2601 E. Roosevelt, Phoenix 85008, USA.

American Journal of Surgery
|December 19, 2002
PubMed
Summary

Implementing continuous renal replacement therapy (CRRT) improved care for critically ill patients, with burn patients achieving revenue neutrality. This specialized dialysis program demonstrated potential for better outcomes and cost-effectiveness.

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Area of Science:

  • Critical Care Medicine
  • Nephrology
  • Health Services Research

Background:

  • Critically ill patients often suffer acute renal failure, increasing hospital stays and costs.
  • Standard dialysis can be ineffective and costly in this population.
  • A revenue-neutral dialysis program improving patient care and outcomes is desirable.

Purpose of the Study:

  • To establish an in-house continuous renal replacement therapy (CRRT) program for critically ill patients.
  • To assess the impact of CRRT on patient care, financial performance, and mortality rates.
  • To determine if CRRT can be a revenue-neutral intervention.

Main Methods:

  • Developed a CRRT program utilizing advanced equipment and specialized training.
  • Created a dedicated CRRT team and collaborated with the hospital business office for billing.

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  • Analyzed financial records including costs, billing, revenue, reimbursement, and payer data for CRRT patients.

    • Main Results:

    • The CRRT program incurred an initial cost of $79,622.80 and $222,323.98 for treatment.
    • Despite potential revenue of $656,090.63, actual billing was $386,794.32, with $165,779.86 reimbursed.
    • Burn patients undergoing CRRT showed a net profit of $10,294.12 and lower mortality rates (65%) compared to national averages.

    Conclusions:

    • An in-house CRRT program enhances care for critically ill patients, including those unable to tolerate traditional dialysis.
    • While overall revenue was lost, CRRT in burn patients approached revenue neutrality.
    • Observed mortality rates, particularly in burn patients, were lower than published averages, suggesting improved outcomes.