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A comparison of intensive care unit physician staffing costs at the 3 Mayo Clinic sites
Eric L Bloomfield1, Gavin D Divertie, Charles D Burger
1Department of Critical Care, Mayo Clinic College of Medicine, 4500 San Pablo Rd, Jacksonville, FL 32224, USA. bloomfield.eric@mayo.edu
Insights
Utilizing residents and fellows for intensive care unit (ICU) staffing is more cost-effective than employing nonphysician providers (NPPs). This study highlights potential cost savings in healthcare delivery models.
Area of Science:
- Healthcare Management
- Medical Economics
- Critical Care Services
Background:
- Intensive Care Unit (ICU) services represent a significant healthcare cost.
- Optimizing staffing models is crucial for managing provider expenses.
- Comparing physician trainees with nonphysician providers (NPPs) offers insights into cost-efficiency.
Purpose of the Study:
- To determine the provider cost of ICU services.
- To compare the cost-effectiveness of three distinct ICU staffing models.
- To evaluate the financial implications of using house staff versus NPPs for ICU coverage.
Main Methods:
- Data on ICU staff composition and bed numbers were collected from three Mayo Clinic sites (2004-2004).
- Total staffing costs per ICU bed per year were calculated using institutional/national average salaries.
- Medicare medical education reimbursements were incorporated into the cost analysis.
Main Results:
- Physician staffing costs per ICU bed varied by site: $18,630 (Rochester), $37,515 (Jacksonville), and $38,010 (Scottsdale).
- Substituting NPPs for house staff resulted in higher costs per bed: $72,466 (Rochester), $61,291 (Jacksonville), and $49,909 (Scottsdale).
- Incremental costs for using NPPs were $53,836 (Rochester), $23,776 (Jacksonville), and $11,899 (Scottsdale).
Conclusions:
- Employing residents and fellows for ICU staffing is more cost-efficient than utilizing NPPs at major tertiary health centers.
- These findings suggest implications for physician service costs in non-teaching community hospitals.
- The study underscores the impact of staffing choices on the overall cost of critical care delivery.
Objectives:
To determine the provider cost of administering intensive care unit (ICU) services, comparing 3 different staffing models for ICU coverage, and to compare the costs of using house staff vs nonphysician providers (NPPs).
Methods:
Data were collected on total staff composition and number of beds In ICUs from January 1, 2004, through December 31, 2004, at the 3 Mayo Clinic sites: Rochester, Minn; Jacksonville, Fla; and Scottsdale, Ariz. Institutional or national average staff salaries were used to determine total staffing costs per ICU bed per year at each site. Medicare medical education reimbursements were also taken into account.
Results:
Costs per ICU bed for physician staffing were $18,630 in Rochester, $37,515 in Jacksonville, and $38,010 in Scottsdale. When NPPs were substituted for house staff, the costs per bed were $72,466 in Rochester, $61,291 in Jacksonville, and $49,909 in Scottsdale. Incremental costs per ICU bed using NPPs were $53,836 in Rochester, $23,776 in Jacksonville, and $11,899 in Scottsdale.
Conclusion:
Use of residents and fellows in ICU staffing at a major tertiary health center is more cost-efficient than use of NPPs. This finding could have Implications for the cost of physician services in nonteaching community hospitals and the methods by which care is provided.
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