Abstract
Background: Evaluate patterns in existing cost data for patients with respiratory illness managed in a large academic Pediatric Intensive Care Unit (PICU), with the goal to identify targets for potential cost-management strategies. Methods: Retrospective, observational study of patients admitted to a 34-bed multidisciplinary PICU from October 2011 to September 2012. Study design: Variable direct costs (VDC) for each All Patient Refined Diagnosis Related Group (APR DRG) were obtained from the Decision Support Group and detailed analysis was performed for top respiratory APR DRGs. Results: During the study period, 1,999 patients were admitted to the PICU equating to 17,053 PICU days. Medical critical care patients accounted for 54% of all admissions and 46% PICU days. The top 5 respiratory-related APR DRGs accounted for almost 45% of all PICU medical admissions. Non-asthma respiratory-related APR DRGs accounted for 23% of medical admission and 18% of medical PICU days. Of the total VDC for this subgroup, 54% and 20% was attributed to nursing and respiratory care respectively, with a significant minority (<10% ) on pharmacy and laboratory services. Further analysis of the VDC for respiratory care indicated one-third of all costs are incurred for pulmonary hygiene care, another third for delivery of bronchodilator therapy, and just 16.4% for mechanical ventilation. Conclusion: Analysis of VDC in context of APR DRG can indicate areas for potential cost management strategies. A high percentage of respiratory care costs accounted for pulmonary clearance interventions. This type of cost analysis may identify potential targets for cost-management interventions in various PICU populations.
Highlights
The cost of providing critical care has increased substantially over the past decade
A high percentage of respiratory care costs accounted for pulmonary clearance interventions
Expenditures in the United States related to critical care medicine were $56.6 billion in 2000, but grew to $81.7 billion by 2005 [1]
Summary
The cost of providing critical care has increased substantially over the past decade. Expenditures in the United States related to critical care medicine were $56.6 billion in 2000, but grew to $81.7 billion by 2005 [1]. According to the Society of Critical Care Medicine, the cost of adult and pediatric intensive care in the United States between 2000 and 2005 accounted for 13.4 % of hospital costs and 4.1% of national health expenditures [2]. In 2012, the United States devoted 17% of its Gross Domestic Product to health care related expenditures (most European countries spend between 8-12%) with more resources to critical care services than almost any other country [3,4]. Evaluate patterns in existing cost data for patients with respiratory illness managed in a large academic Pediatric Intensive Care Unit (PICU), with the goal to identify targets for potential cost-management strategies
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
