title: Intensive care costing methodology: cost benefit analysis of mask continuous positive airway pressure for severe cardiogenic pulmonary oedema.
abstract: Costing data for intensive care admissions is important, not only for unit funding, but also for cost outcome analysis of new therapies. This paper presents an intensive care episode costing methodology using the example of a cost-benefit analysis of mask CPAP for severe cardiogenic pulmonary oedema (CPO). This analysis examines the intervention of admitting all patients with severe CPO to the intensive care unit for mask CPAP, compared with the previous practice of admitting only patients failing conventional non-CPAP treatment and requiring mechanical ventilation. The episode costs were determined from a prospective study which showed mask CPAP reduced the need for mechanical ventilation from 35% to 0%. The mean cost of a mask CPAP episode was $1,156, with a mean stay of 1.2 days, compared with ventilated patients, $5,055 and 4.2 days. The major contributors to cost in both groups were nursing and medical salaries, and hospital overheads. The cost of previous estimated yearly caseload of 35 ventilated patients ($176,925) was greater than the cost associated with an increased caseload of 100 mask CPAP patients ($115,600). We conclude that, despite an increase in admissions, mask CPAP for severe CPO is cost-effective.
authors.affiliation: Department of Anaesthesia and Intensive Care, Flinders Medical Centre, Adelaide, South Australia.
authors.forename: A W
authors.initials: AW
authors.lastname: Holt
authors.forename: A D
authors.initials: AD
authors.lastname: Bersten
authors.forename: S
authors.initials: S
authors.lastname: Fuller
authors.forename: R K
authors.initials: RK
authors.lastname: Piper
authors.forename: L I
authors.initials: LI
authors.lastname: Worthley
authors.forename: A E
authors.initials: AE
authors.lastname: Vedig
mesh_terms: D003362:Cost-Benefit Analysis; D003422:Critical Care / Q000191:economics*; D016527:Drug Costs; D004865:Equipment and Supplies, Hospital / Q000191:economics; D006331:Heart Diseases / Q000150:complications; D017721:Hospital Costs; D006801:Humans; D007362:Intensive Care Units / Q000191:economics; D007902:Length of Stay / Q000191:economics; D008397:Masks / Q000191:economics; D008505:Medical Staff, Hospital / Q000191:economics; D009741:Nursing Staff, Hospital / Q000191:economics; D010337:Pathology Department, Hospital / Q000191:economics; D010814:Physical Therapy Department, Hospital / Q000191:economics; D011175:Positive-Pressure Respiration / Q000191:economics* / Q000295:instrumentation; D011654:Pulmonary Edema / Q000209:etiology / Q000628:therapy*; D011872:Radiology Department, Hospital / Q000191:economics; D012456:Salaries and Fringe Benefits