Cost of intensive therapy. A description of methodology and initial results

A preliminary study was performed to calculate the cost of intensive therapy on an individual patient basis. The fixed (equipment, supporting services and land opportunity), semi-fixed (staff) and marginal (treatment) costs of 20 critically ill patients were calculated individually. The results show that there is wide variation in intensive therapy costs. The average daily cost for a spontaneously breathing patient was 399 pounds (95% confidence intervals 388 pounds-460 pounds) while that for a ventilated patient was 726 pounds (656 pounds-795 pounds). The mean total cost per patient was 1980 pounds, but the cost per survivor increased by 16% (347 pounds) because of four deaths on the intensive care unit. High total costs are associated with increased severity of illness and higher marginal (treatment) costs are associated with increased semi-fixed (staff) costs. The cost of intensive therapy was three to five times that for general ward care.