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Charging for intensive care using direct nursing hours as the cost marker
J H Havill1, M Caspari, H McConnell
1Critical Care Department, Waikato Hospital, Hamilton, New Zealand.
Anaesthesia and Intensive Care
|August 1, 1997
Summary
Direct nursing hours strongly correlate with intensive care patient costs, offering a simple method for cost allocation. This finding aids in understanding and managing healthcare expenses in critical care settings.
Area of Science:
- Healthcare Economics
- Nursing Management
- Critical Care Medicine
Background:
- Accurate patient cost allocation is crucial for healthcare management.
- Intensive care units (ICUs) represent a significant cost center in hospitals.
- Understanding cost drivers in ICUs is essential for resource optimization.
Purpose of the Study:
- To test the hypothesis that direct nursing hours correlate with the cost of a patient stay in intensive care.
- To establish a relationship between nursing workload and patient costs.
- To identify a practical method for ICU cost allocation.
Main Methods:
- Studied 139 intensive care patients.
- Collected data on direct nursing hours per patient.
- Recorded daily Therapeutic Intervention Scoring System (TISS) scores.
- Performed detailed patient costing in N.Z. dollars.
Main Results:
- A strong correlation (r² = 0.98) was found between direct nursing hours and total patient cost (Total Cost = 54 x Direct Nursing Hours + 344).
- A strong correlation (r² = 0.96) was observed between total TISS scores and total patient cost (Total Cost = 67.13 x TISS).
- Direct nursing hours proved to be a simple and logical cost allocation method.
Conclusions:
- Direct nursing hours are a highly reliable predictor of intensive care patient costs.
- Nursing workload is a primary driver of ICU expenses.
- Direct nursing hours provide a practical and effective tool for allocating costs in intensive care settings.