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Does a single specialty intensive care unit make better business sense than a multi-specialty intensive care unit? A costing study in a trauma center in India.

Kumar P, Jithesh V, Gupta SK - Saudi J Anaesth (2015 Apr-Jun)

Bottom Line: Fisher's two-tailed t-test.The cost center wise and overall difference in the cost among the ICUs were statistically significant.Although multi-specialty ICUs are more expensive, other factors will also play a role in defining the kind of ICU that need to be designed.

View Article: PubMed Central - PubMed

Affiliation: Department of Hospital Administration, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

ABSTRACT

Context: Though intensive care units (ICUs) only account for 10% of hospital beds, they consume nearly 22% of hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation.

Aim: To evaluate and compare the cost of intensive care delivery between multi-specialty and neurosurgery ICU in an apex trauma care facility in India.

Materials and methods: The study was conducted in a polytrauma and neurosurgery ICU at a 203 bedded level IV trauma care facility in New Delhi, India from May, 2012 to June 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management.

Statistical analysis: Fisher's two-tailed t-test.

Results: Total cost/bed/day for the multi-specialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU was Rs. 14,306.7/-, manpower constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant.

Conclusions: Quantification of expenditure in running an ICU in a trauma center would assist healthcare decision makers in better allocation of resources. Although multi-specialty ICUs are more expensive, other factors will also play a role in defining the kind of ICU that need to be designed.

No MeSH data available.


Related in: MedlinePlus

The cost center center wise differences between neurosurgery and multi-specialty intensive care units (ICUs) of trauma center are depicted in the figure. Though the consumable, nonclinical support services cost and equipment cost is higher in the neurosurgery ICU, with the overall cost is lower than multi-specialty ICU primarily because of the manpower and estates costs
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Figure 3: The cost center center wise differences between neurosurgery and multi-specialty intensive care units (ICUs) of trauma center are depicted in the figure. Though the consumable, nonclinical support services cost and equipment cost is higher in the neurosurgery ICU, with the overall cost is lower than multi-specialty ICU primarily because of the manpower and estates costs

Mentions: Viewed from an entirely financial perspective, neurosurgery ICU outweighs the benefits of a multi-specialty trauma ICU [Figure 3]. This maybe because the manpower, forming the largest chunk of expenditure, being from the same specialty can probably be utilized more effectively. Second, although the consumable cost is higher considering it is a neurosurgery ICU, this is offset by the fact the similar structural and engineering cost drives down the capital and maintenance cost. Further, the clinical profile of the patients being similar, may have brought down the cost of the clinical support services in neurosurgery ICU as against the multi-specialty ICU. However, outcomes need to be viewed from the clinical prism as well, since multi-specialty ICUs would provide the opportunity to treat the patient more holistically and permit inter unit transfers, cross consultation and promote pooling of resources.


Does a single specialty intensive care unit make better business sense than a multi-specialty intensive care unit? A costing study in a trauma center in India.

Kumar P, Jithesh V, Gupta SK - Saudi J Anaesth (2015 Apr-Jun)

The cost center center wise differences between neurosurgery and multi-specialty intensive care units (ICUs) of trauma center are depicted in the figure. Though the consumable, nonclinical support services cost and equipment cost is higher in the neurosurgery ICU, with the overall cost is lower than multi-specialty ICU primarily because of the manpower and estates costs
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4374226&req=5

Figure 3: The cost center center wise differences between neurosurgery and multi-specialty intensive care units (ICUs) of trauma center are depicted in the figure. Though the consumable, nonclinical support services cost and equipment cost is higher in the neurosurgery ICU, with the overall cost is lower than multi-specialty ICU primarily because of the manpower and estates costs
Mentions: Viewed from an entirely financial perspective, neurosurgery ICU outweighs the benefits of a multi-specialty trauma ICU [Figure 3]. This maybe because the manpower, forming the largest chunk of expenditure, being from the same specialty can probably be utilized more effectively. Second, although the consumable cost is higher considering it is a neurosurgery ICU, this is offset by the fact the similar structural and engineering cost drives down the capital and maintenance cost. Further, the clinical profile of the patients being similar, may have brought down the cost of the clinical support services in neurosurgery ICU as against the multi-specialty ICU. However, outcomes need to be viewed from the clinical prism as well, since multi-specialty ICUs would provide the opportunity to treat the patient more holistically and permit inter unit transfers, cross consultation and promote pooling of resources.

Bottom Line: Fisher's two-tailed t-test.The cost center wise and overall difference in the cost among the ICUs were statistically significant.Although multi-specialty ICUs are more expensive, other factors will also play a role in defining the kind of ICU that need to be designed.

View Article: PubMed Central - PubMed

Affiliation: Department of Hospital Administration, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

ABSTRACT

Context: Though intensive care units (ICUs) only account for 10% of hospital beds, they consume nearly 22% of hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation.

Aim: To evaluate and compare the cost of intensive care delivery between multi-specialty and neurosurgery ICU in an apex trauma care facility in India.

Materials and methods: The study was conducted in a polytrauma and neurosurgery ICU at a 203 bedded level IV trauma care facility in New Delhi, India from May, 2012 to June 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management.

Statistical analysis: Fisher's two-tailed t-test.

Results: Total cost/bed/day for the multi-specialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU was Rs. 14,306.7/-, manpower constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant.

Conclusions: Quantification of expenditure in running an ICU in a trauma center would assist healthcare decision makers in better allocation of resources. Although multi-specialty ICUs are more expensive, other factors will also play a role in defining the kind of ICU that need to be designed.

No MeSH data available.


Related in: MedlinePlus