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Decrease in costs for management of lower airway disease in the pediatric intensive care unit
J Irazuzta1, J Zhang, S Pandit
1Robert C. Byrd Health Sciences Center, West Virginia University--Charleston Division, USA.
Insights
Costs for pediatric intensive care decreased over four years for lower airway disease patients. This reduction in patient-originated costs suggests a learning curve effect among the critical care team.
Area of Science:
- Pediatric Critical Care Medicine
- Healthcare Economics
- Hospital Administration
Background:
- Investigated cost changes in a pediatric intensive care unit (PICU) after restructuring.
- Examined patient care costs over a four-year period.
Purpose of the Study:
- To determine if a restructured pediatric intensive care unit (PICU) experienced a decrease in patient care costs.
- To identify factors influencing cost changes in pediatric critical care.
Main Methods:
- Retrospective study of 89 previously healthy patients treated for lower airway disease (1991-1994).
- Collected data included patient demographics, illness severity, length of stay, hospital bills, and patient-originated costs (POC).
Main Results:
- Patient-originated costs (POC) decreased over the four-year study period.
- Diagnostic test costs declined by 58%; decreases in POC correlated with lower hospital bills.
- Increased illness severity and intubation were associated with higher costs, but the overall downward trend persisted after adjustments.
Conclusions:
- Management costs for pediatric lower airway disease patients decreased significantly over the study period.
- The observed cost reduction is hypothesized to be due to the pediatric critical care team's learning curve.
- Cost decreases in the PICU did not result in cost shifting to other hospital departments.
Background:
We investigated whether a recently restructured pediatric intensive care unit (PICU) had a decrease in the cost of patient care over the years.
Methods:
We retrospectively studied 89 previously healthy patients admitted to the PICU of a community-based, university-affiliated teaching hospital over a 4-year period (1991 to 1994) for treatment of lower airway disease. Data collected were patient age, severity of illness, length of stay in both PICU and hospital, prorated hospital bill, year of admission, and patient-specific PICU-originated costs (POC).
Results:
There was a decrease of POC over the 4-year period, though two factors were associated with a cost increase in this group of patients: an increase in the severity of illness and intubation. The decrease over the years remained present even when excluding intubated patients and adjusting for severity of illness. A decline of 58% below the initial cost for diagnostic tests was the most prominent of all the individual areas studied. Decreases in POC correlated with decreases in the prorated hospital bill.
Conclusions:
The costs of management for these previously healthy patients treated for lower airway disease decreased over the study period. We speculate that the time related decrease in costs is a reflection of the learning curve of the pediatric critical care team. The decrease in POC did not shift costs to other areas of the hospital.
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