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Related Experiment Videos

Relationship between TISS and ICU cost

H Dickie1, A Vedio, R Dundas

  • 1Department of Intensive Care, St Thomas' Hospital, London, UK.

Intensive Care Medicine
|December 5, 1998
PubMed
Summary
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The Therapeutic Intervention Scoring System (TISS) accurately reflects intensive care unit (ICU) population and subgroup costs. However, TISS is less reliable for predicting individual patient costs within the ICU.

Area of Science:

  • Health Economics
  • Critical Care Medicine
  • Healthcare Management

Background:

  • Accurate cost assessment in Intensive Care Units (ICUs) is crucial for resource allocation and financial management.
  • The Therapeutic Intervention Scoring System (TISS) is widely used to quantify patient acuity and resource utilization.
  • Previous studies have explored the relationship between TISS and ICU costs with varying results.

Purpose of the Study:

  • To evaluate the reliability of the Therapeutic Intervention Scoring System (TISS) in reflecting the costs associated with the overall Intensive Care Unit (ICU) population.
  • To assess TISS's accuracy in representing costs for specific ICU patient subgroups.
  • To determine the correlation between TISS scores and individual patient costs within an ICU setting.

Main Methods:

Related Experiment Videos

  • A prospective analysis was conducted on individual patient costs in a general medical and surgical ICU.
  • Variable costs (consumables, staff services) and fixed costs (salaries, capital) were meticulously measured daily for 257 consecutive patients.
  • Regression analysis was employed to compare patient costs with their corresponding TISS scores.

Main Results:

  • A strong correlation (r=0.87) was found between variable costs and TISS for individual patient days, strengthening to r=0.93 for the entire patient episode.
  • This correlation held true for subgroups: Coronary Care Unit (CCU), Cardiac Surgery (CS), and General ICU (GIC) patients, with minimal cost prediction differences (2.2% for GIC).
  • However, the error margin for individual patient costs reached up to +/- 65% of the actual variable cost.

Conclusions:

  • TISS reliably measures the overall costs of the ICU population and specific patient subgroups (CCU, CS, GIC).
  • The TISS demonstrates a less reliable relationship with actual costs when applied to individual ICU patients.
  • These findings suggest TISS is a valuable tool for macro-level cost analysis but requires caution for micro-level financial assessments.