The development of a method for comparative costing of individual intensive care units

Abstract

SummaryIntensive care is one of the most costly areas of hospital care. Unfortunately, because of the diversity of case mix, costing intensive care is difficult. Many described costing methods previously are limited by being cumbersome, laborious to apply and expensive. The aim of this study was to develop a method for costing intensive care which can be applied with ease but facilitate meaningful cost comparisons between intensive care units. The method developed was based on cost blocks where the major components were identified and costed in a 'top-down' manner. Using strict definitions, the cost blocks attempted to measure the costs of equipment, estates, nonclinical support services (such as hospital management costs), clinical support services (such as physiotherapy, laboratory services), consumables (such as drugs, fluids and disposables) and staff. The study found that clinical support services, consumables and staff costs accounted for approximately 85% of the total costs.

Kosten der intensivmedizinischen Versorgung in einem deutschen Krankenhaus

“…Bei der Top-down-Methode werden Kostengrößen auf einer aggregierten Ebene betrachtet und anhand bestimmter Schlüs-sel sowie Kriterien auf einzelne Patienten verteilt [4, 8,9]. Um die Kosten/ITS-Tag zu errechnen, werden die Jahresgesamtkosten einer ITS durch die Gesamtzahl der Liegetage geteilt [10].…”

Staff cost in direct nursing care at an intensive care unit

“…As shown in the results, the assessment of the nursing team cost through the methodology adopted in this study presented great variations, as demonstrated in other studies (4)(5)(6) . The maximum cost was R$ 3,438.07; mean cost R$ 2,531.13 and minimum cost R$ 1,415.61.…”

“…The hypothesis that nursing care is directly proportional to their cost was confirmed in studies through the Therapeutic Intervention Scoring System, TISS-28 (4)(5)(6) . They have demonstrated that the use of this index to measure direct nursing care hours revealed to be a logical and relatively simple method of cost allocation per patient at ICUs.…”

A comparison of clinical trial and model-based cost estimates in glaucoma – The case of repeat laser trabeculoplasty In Ontario

“…This is in contrast to the situation in inpatient care or intensive care where labour is a large component of cost and it varies largely between patients. [21,22] The stability of our clinical scenario is likely aided by the availability of relatively cheap generic drugs, thus differences in drug regimen failed to substantially alter cost estimates.…”