A comparison of intensive care unit physician staffing costs at the 3 Mayo Clinic sites.
OBJECTIVE
To determine the provider cost of administering intensive care unit (ICU) services, comparing 3 different staffing models for ICU coverage, and to compare the costs of using house staff vs nonphysician providers (NPPs).


METHODS
Data were collected on total staff composition and number of beds In ICUs from January 1, 2004, through December 31, 2004, at the 3 Mayo Clinic sites: Rochester, Minn; Jacksonville, Fla; and Scottsdale, Ariz. Institutional or national average staff salaries were used to determine total staffing costs per ICU bed per year at each site. Medicare medical education reimbursements were also taken into account.


RESULTS
Costs per ICU bed for physician staffing were $18,630 in Rochester, $37,515 in Jacksonville, and $38,010 in Scottsdale. When NPPs were substituted for house staff, the costs per bed were $72,466 in Rochester, $61,291 in Jacksonville, and $49,909 in Scottsdale. Incremental costs per ICU bed using NPPs were $53,836 in Rochester, $23,776 in Jacksonville, and $11,899 in Scottsdale.


CONCLUSIONS
Use of residents and fellows in ICU staffing at a major tertiary health center is more cost-efficient than use of NPPs. This finding could have Implications for the cost of physician services in nonteaching community hospitals and the methods by which care is provided.
Bloomfield
Eric L
EL
Department of Critical Care, Mayo Clinic College of Medicine, 4500 San Pablo Rd, Jacksonville, FL 32224, USA. bloomfield.eric@mayo.edu
Divertie
Gavin D
GD
Burger
Charles D
CD
Larson
Joel S
JS
Brown
Daniel R
DR
Patel
Bhavesh M
BM
Rady
Mohamed Y
MY
Johnson
Margaret M
MM
Murray
Michael J
MJ
D001130:Arizona; D003365:Costs and Cost Analysis; D005431:Florida; D006801:Humans; D007362:Intensive Care Units / Q000191:economics*; D008910:Minnesota; D010561:Personnel Staffing and Scheduling / Q000191:economics*; D010820:Physicians / Q000191:economics*; D012189:Retrospective Studies