Costs and cost-effectiveness of a telemedicine intensive care unit program in 6 intensive care units in a large health care system.
Costs and cost-effectiveness of a telemedicine intensive care unit program in 6 intensive care units in a large health care system.
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DOI：
10.1016/j.jcrc.2010.12.004
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发表时间：
2011-06
影响因子：
3.7
通讯作者：
Wueste, Laura
中科院分区：
文献类型：
--
作者：
Franzini, Luisa;Sail, Kavita R.;Thomas, Eric J.;Wueste, Laura
评估远程ICU项目的成本和成本效益。我们使用了一项观察性研究，在5家医院的6个ICU中，对远程ICU前期间接受护理的ICU患者和远程ICU后期间接受护理的ICU患者进行了观察性研究，这些医院是墨西哥湾沿岸地区大型非营利性医疗保健系统的一部分。我们获得了4142名ICU患者的样本数据：2,034名在远程ICU前，2,108名在远程ICU后。经济结果是医院成本，ICU成本和最低成本，衡量平均每日成本，每个病例的成本，每个病人的成本。实施远程ICU后，医院每日成本从4，302美元增加到5，340美元（24%），每个病例的医院成本从21，967美元增加到31，318美元（43%），每个患者的成本从20，231美元增加到25，846美元（28%）。虽然远程ICU干预在SAPS II ≤ 50的患者中不具有成本效益，但在SAPS II > 50的最严重患者（17%的患者）中具有成本效益，因为它降低了住院死亡率，而没有显著增加成本。医院管理人员可能会得出结论，针对病情最严重的病人的远程ICU计划是成本效益。
To estimate the costs and cost-effectiveness of a tele-ICU program. We used an observational study with ICU patients cared for during the pre-tele-ICU period and ICU patients cared for during the post-tele-ICU period in 6 ICUs at 5 hospitals, part of a large non-profit health care system in the Gulf Coast region. We obtained data on a sample of 4142 ICU patients: 2,034 in the pre-tele-ICU period and 2,108 in the post-tele-ICU period. Economic outcomes were hospital costs, ICU costs and floor costs, measured for average daily costs, costs per case, and costs per patient. After the implementation of the tele-ICU, the hospital daily cost increased from $4,302 to $5,340 (24%), the hospital cost per case from $21,967 to $31,318 (43%), and the cost per patient from $20,231 to $25,846 (28%). While the tele-ICU intervention was not cost effective in patients with SAPS II ≤ 50, it was cost effective in the sickest patients with SAPS II > 50 (17% of patients) as it decreased hospital mortality without increasing costs significantly. Hospital administrators may conclude that a tele-ICU program aimed at the sickest patients is cost effective.
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