title: Therapeutic intervention scoring system (TISS)--a method for measuring workload and calculating costs in the ICU.
abstract: The Therapeutic Intervention Scoring System (TISS) is an easily applicable method for measurement of workload in the intensive care unit (ICU). In the present study a modified TISS-scoring (mTISS) was performed daily during 1988-1989 on 2693 patients in a general ICU. Of these, 900 could be classified as 'true' ICU-patients (ICU-stay > or = 24 h or TISS > or = 20 points), whereas the rest were postoperative. In ICU-patients the average length of stay was 4.5 +/- 8.9 days and the average workload 114 +/- 218 mTISS-points. The workload was not significantly related to age or type of admission (scheduled vs unscheduled). Hospital non-survivors (13.6%) showed a significantly increased mean total mTISS-score (239 +/- 364, P < 0.001). Critically ill (TISS Class IV) patients (14% of the sample), with an average workload of 437 +/- 401 mTISS-points, consumed 53% of the total resources. Patients categorized (ICD-9) to respiratory and infectious diseases showed the greatest average workload (207 +/- 315 and 208 +/- 355 mTISS-points, respectively). A workload-index was also developed relating the actual workload to the ICU personnel. The cost of each mTISS-point was calculated. In conclusion, the present study showed that mTISS is a valuable tool when evaluating resource utilization in the ICU. Together with the proposed workload-index and calculation of costs, mTISS could be used for ICU management control.
authors: Department of Anaesthesiology, County Hospital Gävle, Sweden.
authors: J
authors: J
authors: Mälstam
authors: L
authors: L
authors: Lind
mesh_terms: D000367:Age Factors; D000368:Aged; D002017:Budgets; D003365:Costs and Cost Analysis; D003422:Critical Care / Q000191:economics* / Q000706:statistics & numerical data*; D016638:Critical Illness; D004194:Disease; D017052:Hospital Mortality; D006767:Hospitals, District / Q000191:economics / Q000706:statistics & numerical data; D006769:Hospitals, General / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000191:economics* / Q000706:statistics & numerical data*; D008875:Middle Aged; D010343:Patient Admission; D011182:Postoperative Care; D013548:Sweden / Q000453:epidemiology; D016526:Workload