Sarah Heili-Frades1, María Del Pilar Carballosa de Miguel2, Alba Naya Prieto2, Marina Galdeano Lozano3, Xavier Mate García4, Ignacio Mahillo Fernández5, Itziar Fernández Ormaechea2, Laura Álvarez Suárez2, Farah Ezzine de Blas2, María José Checa Venegas2, Nicolás González Mangado2, Germán Peces Barba2. 1. Unidad de Cuidados Intermedios Respiratorios, Servicio de Neumología, IIS-Fundación Jiménez Díaz Quirón Salud. UAM, Ciberes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias), REVA (Réseau Européen de Ventilation Artificielle), Madrid, España. Electronic address: sheili@fjd.es. 2. Unidad de Cuidados Intermedios Respiratorios, Servicio de Neumología, IIS-Fundación Jiménez Díaz Quirón Salud. UAM, Ciberes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias), REVA (Réseau Européen de Ventilation Artificielle), Madrid, España. 3. Unidad de Cuidados Intermedios Respiratorios, Servicio de Neumología, Hospital Universitario Sagrat Cor, Grupo Quirón Salud. Universitat de Barcelona, REVA (Réseau Européen de Ventilation Artificielle), Barcelona, España. 4. Dirección General y Gerencia, Hospital Universitario Sagrat Cor, Grupo Quirón Salud, Barcelona, España. 5. Departamento de Estadística, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
Abstract
INTRODUCTION: Historically, it has been assumed that Intermediate Respiratory Care Units (IRCU) were efficient, because they saved costs by reducing the number of admissions to intensive care units (ICU), and effective, because they specialized in respiratory diseases. METHODS: The number of IRCU admissions and mortality rate, historically and in 2016, were evaluated. For 2016, the grouped Related Diagnostic Groups (DRGs) were also described, and the savings achieved under all budgetary headings by avoiding UCI stays were calculated. A multivariate analysis was performed to associate costs with mean weights and complexity, and multiple logistic regression was performed on all patients admitted from 2004 to 2017 to describe the variables associated with mortality in our unit. RESULTS: An IRCU generates savings of €500,000/year by reducing length of ICU stay. Analysis of the 2016 cohort shows that costs correlate with mean weight and mortality, and consequently complexity. The multivariate logistic regression analysis of the 2004-2017 cohort found respiratory frequency, leukopenia, anemia, hyperkalemia, and acidosis to be the variables best associated with mortality. The area under the curve for the logistic model was 0.75. CONCLUSION: The IRCU analyzed in our study was efficient in terms of 'avoided costs' and savings associated with complexity. Our results suggest that IRCUs have a lower mortality rate than other similar units, and are therefore a safe environment for patients.
INTRODUCTION: Historically, it has been assumed that Intermediate Respiratory Care Units (IRCU) were efficient, because they saved costs by reducing the number of admissions to intensive care units (ICU), and effective, because they specialized in respiratory diseases. METHODS: The number of IRCU admissions and mortality rate, historically and in 2016, were evaluated. For 2016, the grouped Related Diagnostic Groups (DRGs) were also described, and the savings achieved under all budgetary headings by avoiding UCI stays were calculated. A multivariate analysis was performed to associate costs with mean weights and complexity, and multiple logistic regression was performed on all patients admitted from 2004 to 2017 to describe the variables associated with mortality in our unit. RESULTS: An IRCU generates savings of €500,000/year by reducing length of ICU stay. Analysis of the 2016 cohort shows that costs correlate with mean weight and mortality, and consequently complexity. The multivariate logistic regression analysis of the 2004-2017 cohort found respiratory frequency, leukopenia, anemia, hyperkalemia, and acidosis to be the variables best associated with mortality. The area under the curve for the logistic model was 0.75. CONCLUSION: The IRCU analyzed in our study was efficient in terms of 'avoided costs' and savings associated with complexity. Our results suggest that IRCUs have a lower mortality rate than other similar units, and are therefore a safe environment for patients.
Authors: Marina Galdeano Lozano; Julio César Alfaro Álvarez; Núria Parra Macías; Rosario Salas Campos; Sarah Heili Frades; Josep Maria Montserrat; Antoni Rosell Gratacós; Jorge Abad Capa; Olga Parra Ordaz; Francesc López Seguí Journal: Int J Environ Res Public Health Date: 2022-05-16 Impact factor: 4.614
Authors: Guillermo Suarez-Cuartin; Merce Gasa; Guadalupe Bermudo; Yolanda Ruiz; Marta Hernandez-Argudo; Alfredo Marin; Pere Trias-Sabria; Ana Cordoba; Ester Cuevas; Mikel Sarasate; Albert Ariza; Joan Sabater; Nuria Romero; Cristina Subirana; Maria Molina-Molina; Salud Santos Journal: Front Med (Lausanne) Date: 2021-07-01