title: Surgical ICU underutilization does not significantly discourage discharge.
abstract: An SICU must have sufficient capacity to handle peak weekly demand to prevent re-admission and/or poor quality of care. Excess capacity may, however, encourage unnecessary SICU utilization. The goal of this study was to assess the influence of availability of SICU beds on patient discharge and re-admission rates. The case series included 1,492 days, 36,816 patient days, 8,821 discharges, and 186 re-admissions within 3 days from a 24-bed multidisciplinary SICU at a tertiary care center. Census was defined to equal the total number of patients in the SICU each day. We found low census levels were not associated with significantly lower discharge rates. Decreasing the census from 19-24 to 13-18 patients per day decreased discharge rates from 31% to 30%. Odds ratio that a decrease in census by five from 24 decreased discharge rate equaled 1.01 (95% confidence interval 0.96 to 1.06). We conclude that when hospital managers choose an appropriate SICU capacity they need not be concerned that intermittent excess capacity will prompt physicians to significantly decrease their discharge rates.
authors.affiliation: Department of Anesthesia, University of Iowa, Iowa City 52242, USA.
authors.forename: F
authors.initials: F
authors.lastname: Dexter
authors.forename: K
authors.initials: K
authors.lastname: Pearson
authors.forename: D L
authors.initials: DL
authors.lastname: Griffiths
authors.forename: P
authors.initials: P
authors.lastname: Jebson
mesh_terms: D001509:Bed Occupancy / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand; D006302:Health Services Research / Q000379:methods; D017721:Hospital Costs; D006785:Hospitals, University / Q000706:statistics & numerical data; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007484:Iowa; D016015:Logistic Models; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D011182:Postoperative Care / Q000706:statistics & numerical data*; D012044:Regression Analysis; D014600:Utilization Review / Q000706:statistics & numerical data*