Guido Bertolini1, Carlotta Rossi2, Luca Brazzi3, Danilo Radrizzani4, Giancarlo Rossi5, Enrico Arrighi6, Bruno Simini7. 1. GiViTI Coordinating Center, Istituto di Ricerche Farmacologiche "Mario Negri", Centro di Ricerche Cliniche per le Malattie Rare Aldo e Cele Daccò, 24020 , Ranica , (Bergamo), Italy. bertolini@marionegri.it. 2. GiViTI Coordinating Center, Istituto di Ricerche Farmacologiche "Mario Negri", Centro di Ricerche Cliniche per le Malattie Rare Aldo e Cele Daccò, 24020 , Ranica , (Bergamo), Italy. 3. Istituto di Anestesia e Rianimazione, Ospedale Maggiore Policlinico IRCCS, Milan, Italy. 4. I Servizio di Anestesia e Rianimazione, Ospedale Civile di Legnano, Legnano , (Milan), Italy. 5. I Servizio di Anestesia e Rianimazione, Spedali Riuniti, Livorno, Italy. 6. Istituto di Economia Sanitaria, Milan, Italy. 7. Servizio di Anestesia e Rianimazione, Ospedale Generale Provinciale, Lucca, Italy.
Abstract
OBJECTIVE: We examined the relationship between major ICU characteristics and labour cost per patient. DESIGN: Four-week prospective data collection, in which the hours spent by each physician and nurse on both in-ICU and extra-ICU activities were collected. SETTING: Eighty Italian adult ICUs. MEASUREMENTS AND RESULTS: The cost of the time actually spent by ICU staff on ICU patients (labour cost) was computed for each participating unit, by applying to the average annual salaries the proportions of in-ICU activity working time for physicians and nurses. Multiple regression analysis was used to identify ICU characteristics that predict labour costs per patient. Labour cost per patient was positively correlated with ICU mortality and patients average length of stay (slopes =0.67, p =0.048 and 0.09, p <0.0001, respectively). Labour cost per patient decreases almost linearly as the number of beds increases up to about eight, and it remains nearly constant above about twelve beds. The number of patients admitted per physician (not per nurse) increases with the number of beds (Spearman correlation coefficient =0.567, p <0.0001). CONCLUSIONS: Our findings suggest that ICUs with less than about 12 beds are not cost-effective.
OBJECTIVE: We examined the relationship between major ICU characteristics and labour cost per patient. DESIGN: Four-week prospective data collection, in which the hours spent by each physician and nurse on both in-ICU and extra-ICU activities were collected. SETTING: Eighty Italian adult ICUs. MEASUREMENTS AND RESULTS: The cost of the time actually spent by ICU staff on ICU patients (labour cost) was computed for each participating unit, by applying to the average annual salaries the proportions of in-ICU activity working time for physicians and nurses. Multiple regression analysis was used to identify ICU characteristics that predict labour costs per patient. Labour cost per patient was positively correlated with ICU mortality and patients average length of stay (slopes =0.67, p =0.048 and 0.09, p <0.0001, respectively). Labour cost per patient decreases almost linearly as the number of beds increases up to about eight, and it remains nearly constant above about twelve beds. The number of patients admitted per physician (not per nurse) increases with the number of beds (Spearman correlation coefficient =0.567, p <0.0001). CONCLUSIONS: Our findings suggest that ICUs with less than about 12 beds are not cost-effective.
Authors: J P Braun; B Schwilk; L Kuntz; M Kastrup; U Frei; D Schmidt; B Behrends; A Schleppers; U Kaisers; C Spies Journal: Anaesthesist Date: 2007-03 Impact factor: 1.041
Authors: Hendry R Sawe; Juma A Mfinanga; Salum J Lidenge; Boniventura C T Mpondo; Silas Msangi; Edwin Lugazia; Victor Mwafongo; Michael S Runyon; Teri A Reynolds Journal: BMC Int Health Hum Rights Date: 2014-09-23
Authors: Narendra Rungta; Kapil Gangadhar Zirpe; Subhal B Dixit; Yatin Mehta; Dhruva Chaudhry; Deepak Govil; Rajesh C Mishra; Jeetendra Sharma; Pravin Amin; B K Rao; G C Khilnani; Kundan Mittal; Pradip Kumar Bhattacharya; A K Baronia; Yash Javeri; Sheila Nainan Myatra; Neena Rungta; Ranvir Tyagi; Sanjay Dhanuka; Mahesh Mishra; Srinivas Samavedam Journal: Indian J Crit Care Med Date: 2020-01