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Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
The intermediate care unit as a cost-reducing critical care facility in tertiary referral hospitals: a single-centre
Joost D J Plate1, Linda M Peelen2, Luke P H Leenen3
1Surgery, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands.
Objectives:
To determine whether and to what extent the surgical intermediate care unit (IMCU) reduces healthcare costs.
Design:
Retrospective cohort study.
Setting:
The mixed-surgical IMCU of a tertiary academic referral hospital.
Participants:
All admissions (n=2577) from 2012 to 2015.
Primary And Secondary Outcome Measures:
The outcome measure was the hypothetical cost savings due to the presence of the IMCU. For this, each admission day was classified as either low-acuity or high-acuity, based on the Therapeutic Intervention Scoring System-28, the required specific nursing interventions and the indication for admission at the IMCU. Costs (2018) used were €463 per hospital ward, €1307 per IMCU and €2224 per intensive care unit (ICU) admission day. Savings were calculated by subtracting the actual IMCU costs from the hypothetical costs in the absence of the IMCU.
Results:
There were 9037 admission days (n=2577 admissions) at the IMCU. The proportion of high-acuity admissions was 87.6%. Total costs at the IMCU were €11.808 888. Total hypothetical costs in absence of the IMCU were €18.115 284. Total cost savings were thus €6.306 395, or €1.576 599, per year.
Conclusions:
The surgical IMCU may substantially reduce societal healthcare costs, making it a cost saving alternative to ICU care. Constant adequate triage is essential to optimise its potential.
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