Cost Analysis Of An Intermediate Respiratory Care Unit. Is It Really Efficient And Safe?

Introduction: Historically it has been assumed that the Intermediate Respiratory Care Units (IRCU) were efficient hospital structures mainly due to the avoided costs attributable to the reduction of stay in the intensive care units (ICU) and effective because of their pulmonology specialization. Methods: We evaluated admissions and mortality in the unit, historically and in 2016. In that year, the Related Diagnostic Groups were described as well as the avoided cost per ICU stay based on all budget chapters. A multivariate analysis was performed to associate costs to average weights and complexity, and multiple logistic regression analysis was performed on all patients admitted from 2004 to 2017 to describe the variables associated with mortality in our unit. Results: An IRCU avoids a cost to the hospital of 500,000 euros / year by reducing days of stay in the ICU. The 2016 Poisson Regression analysis relate costs to mortality and average weiths. The multivariate logistic regression analysis describes the respiratory frequency, leukopenia, anemia, hyperkalemia and acidosis as the variables that are best associated with mortality. The Area Under the Curve (AUC )for the logistic model was 0.75. Conclusion: The present study describes, on the one hand, the efficiency in the form of “avoided cost” and, on the other hand, confirms that it is a safe environment for patients by markedly reducing the mortality rate.