Reducing the costs of ICU admission in Canada without diagnosis-related or case-mix groupings

A prospective analysis of the cost of intensive care was carried out on 67 admissions to a multidisciplinary ICU. Admissions were grouped and investigated according to various criteria such as admitting diagnosis, admission status (elective vs emergency), severity of illness and outcome. Total ICU admission costs, total per diem ICU costs and per diem costs divided into fixed and variable cost items for the patient groups are reported. Lower total and per diem ICU charges were observed for elective surgical patients, patients with lower severity of illness as assessed by the Therapeutic Intervention Scoring system and survivors. Emergency admissions were more expensive than elective admissions when compared for total ICU admission costs. Length of stay was a significant factor in overall ICU costs. Within the variable cost items, the diagnostic laboratory was the single most costly item per day. As a result of this analysis, the authors propose several suggestions for reducing ICU costs independent of case-mix or diagnosis-related groupings of ICU patients.