Cost Savings Associated with Reducing ICU Length of Stay in Canada, 2012-2013
CCCF ePoster library. Evans J. Oct 31, 2016; 150921; 42
Jessica Evans
Jessica Evans
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Topic: Basic or Translational Science

Cost Savings Associated with Reducing ICU Length of Stay in Canada, 2012-2013


Evans, Jessica1; Kyeremanteng, Kwadwo2,3

Department of Medicine, University of Ottawa/ The Ottawa Hospital, Ottawa, Ontario, Canada; 2  Division of Palliative Care, The Ottawa Hospital, Ottawa, Ontario, Canada; 3 Critical Care Medicine, Montfort Hospital/ The Ottawa Hospital, Ottawa, Ontario, Canada



Abstract:

INTRODUCTION:
The proportion of Intensive Care Unit (ICU) direct expenses in Ontario have been reported to be 2-fold greater relative to the associated proportion of inpatient days.1 There are currently no studies in Canada which explore potential cost-savings associated with reducing ICU length of stay (LOS). 

OBJECTIVE: 
The objective of the current study is to assess the impact of reducing ICU LOS on hospital costs at The Ottawa Hospital.

METHODS:
Data Source: Average daily variable and fixed cost data was retrieved through The Ottawa Hospital Data Warehouse for all new patient encounters between April 2012 and March 2013.
Population: All patients admitted to the ICU (n=2063) between April 2012 to March 2013.
Data Analysis: Mean daily variable direct (VD) costs for ICU encounters were analyzed by admission day number and were compared to mean daily VD costs for non-ICU admissions. A subgroup analysis of VD costs associated with repeat ICU encounters was undertaken.

RESUTLTS:
The mean daily VD cost per ICU patient was $2472 (70% of total daily ICU costs per patient). VD cost is greatest on the first day ICU admission ($3708), but then decreases by 40% to plateau by the third day of admission. In comparison, daily mean VD costs for non-ICU admissions were 81% less compared to those associated with ICU admission day 1, and 69% less compared to ICU admission days ≥3. Among patients with ICU stays >5 days, reducing LOS by 1 day yields a cost savings of $2 million (0.6% of total in-patient costs).  In the study period, there were 119 repeat ICU admissions, representing a VD cost of $355,691 (0.11% of total in-patient costs).

CONCLUSION: Previously held notions that reducing ICU length of stay represents a source of significant hospital cost-savings have been demonstrated to be inaccurate given that many ICU costs are fixed and occur early in an admission. The results of this study can be used to inform meaningful cost-saving strategies for similar acute care centers across Canada.


References:
1 Leeb, K; Jokovic, A.; Sandhu, M.; Zinck, G. Intensive care in Canada. Healthcare Quarterly. 2006; 9(1).

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