Economic Benefit of a Novel Intensivist Coverage in a Surgical ICU

Abstract

Objective. To assess the cost implications of changing the ICU staffing model from a mandatory 24-hour in-house critical care specialist presence to a 16-hour coverage model with external supervision. Design. A pre–post comparison was undertaken among the prospectively assessed cohorts of patients admitted to our surgical ICU over a period of 3 years. Our data were stratified by case mixed index. Costs were modeled using a generalized linear model with log-link and gamma-distributed errors. Setting. Tertiary medical facility. Patients. All patients admitted to the adult surgical intensive care unit during the study period of June 2007 to April 2013. Intervention. Changing the ICU staffing model from a mandatory 24/7 in-house critical care specialist presence to a 16/7 model with robotic rounding in off hours. Results. A total cost model was calculated and evaluated. Total cost estimates of hospitalization were calculated for each patient. Length of stay and mortality were evaluated. Adjusted mean total co...