Yin Nwe Aung1, Amrizal M Nur2, Aniza Ismail3, Syed M Aljunid4. 1. Department of Pathology and Community Medicine, Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur, Malaysia; International Center for Casemix and Clinical Coding, Universiti Kebangsaan Malaysia, Bangi, Malaysia. Electronic address: yinnweaung@gmail.com. 2. International Center for Casemix and Clinical Coding, Universiti Kebangsaan Malaysia, Bangi, Malaysia. 3. Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Malaysia. 4. International Center for Casemix and Clinical Coding, Universiti Kebangsaan Malaysia, Bangi, Malaysia; Department of Health Policy and Management, Faculty of Public Health, Kuwait University, Kywait City, Kuwait.
Abstract
OBJECTIVES: Escalating healthcare costs calls for the efficiency of health services, especially in the intensive care unit (ICU) where the bulk of resources are used. This study aims to identify the length of stay (LOS) and cost of care at ICUs, which are proxy indicators of efficiency and the factors determining them. METHODS: A cross-sectional study of patients requiring ICU admissions in a teaching hospital in Malaysia from 2013 to 2015 was conducted. The cost at the ICU was estimated using the step down approach. Factors that determined the cost and LOS at the ICU were also explored by using multivariate regression analysis. RESULTS: Each day of stay cost $427 (USD) at the pediatric intensive care unit and $1324 at the general intensive care unit. The mean LOS at the ICU was 5.7 days (standard deviation [SD]: 8.4) with a median of 4 days (95% confidence interval [CI] 1-16.7 days). Average cost of care at the ICU per episode of care was $5473 (SD $6499), and the median was $3463. ICU patients spent 29.3% of the total stay and 47.2% of the cost at ICU units. Upon multivariate regression analysis, severity, case base-group, and type of ICU that the patient was admitted to were associated with the cost and LOS at ICU. CONCLUSIONS: Compared with critical care practices in hospitals from more developed nations, a Malaysian teaching hospital required a longer length of ICU stay. Hence, implementations of strategies that can reduce the length of stay and hospital costs without compromising healthcare quality are required.
OBJECTIVES: Escalating healthcare costs calls for the efficiency of health services, especially in the intensive care unit (ICU) where the bulk of resources are used. This study aims to identify the length of stay (LOS) and cost of care at ICUs, which are proxy indicators of efficiency and the factors determining them. METHODS: A cross-sectional study of patients requiring ICU admissions in a teaching hospital in Malaysia from 2013 to 2015 was conducted. The cost at the ICU was estimated using the step down approach. Factors that determined the cost and LOS at the ICU were also explored by using multivariate regression analysis. RESULTS: Each day of stay cost $427 (USD) at the pediatric intensive care unit and $1324 at the general intensive care unit. The mean LOS at the ICU was 5.7 days (standard deviation [SD]: 8.4) with a median of 4 days (95% confidence interval [CI] 1-16.7 days). Average cost of care at the ICU per episode of care was $5473 (SD $6499), and the median was $3463. ICU patients spent 29.3% of the total stay and 47.2% of the cost at ICU units. Upon multivariate regression analysis, severity, case base-group, and type of ICU that the patient was admitted to were associated with the cost and LOS at ICU. CONCLUSIONS: Compared with critical care practices in hospitals from more developed nations, a Malaysian teaching hospital required a longer length of ICU stay. Hence, implementations of strategies that can reduce the length of stay and hospital costs without compromising healthcare quality are required.
Authors: Trinh Manh Hung; Nguyen Van Hao; Lam Minh Yen; Angela McBride; Vu Quoc Dat; H Rogier van Doorn; Huynh Thi Loan; Nguyen Thanh Phong; Martin J Llewelyn; Behzad Nadjm; Sophie Yacoub; C Louise Thwaites; Sayem Ahmed; Nguyen Van Vinh Chau; Hugo C Turner Journal: Front Public Health Date: 2022-06-20