Intensive care reimbursement practices: results from the ICUFUND survey.
OBJECTIVE
To assess patterns of intensive care reimbursement practices.


METHODS
A detailed questionnaire about basic intensive care unit (ICU) characteristics and ICU reimbursement practices was created, and then members of the European Society of Intensive Care (ESICM) were asked by e-mail to participate in the survey and complete the web-based questionnaire.


RESULTS
There were a total of 447 responses analyzed. Of respondents, 51.5% stated that their ICU received detailed financial information; however, only 15.4% of respondents could identify each cost item for each patient. A majority of respondents (77.6%) stated that their unit's reimbursement system was included in the hospital reimbursement. ICU reimbursement systems were most commonly based on previous year's ICU expenditure (51.0%) and diagnosis-related group weights (36%). Selecting European respondents (n = 306) showed that supplying detailed financial information makes ICU doctors significantly more satisfied (p = 0.019) with their reimbursement system. Regarding ICU funding elements, the most satisfied with their ICU reimbursement system were those respondents from ICUs where nursing workload score was used (p = 0.018).


CONCLUSIONS
Our result indicates that ICU physicians who receive detailed financial information about their units are more satisfied with their reimbursement system than those not receiving this information. Nursing workload score may have advantage over other forms of reimbursement practices. ICU physicians would like to be more involved in their unit's financial aspects and would prefer separate funding from hospital.
Department of Anaesthesia and Intensive Care, Institute of Surgery, Semmelweis University, Budapest, Hungary. acsomos@t-online.hu.
Akos
A
Csomos
Institute of Anaesthesia and Intensive Care, University of Pecs, Pecs, Hungary.
Szilard
S
Varga
Instituto di Riserche Farmacologiche, Unita di Epidemiologica Clinica, Ranica (Bergamo), Italy.
Guido
G
Bertolini
Health Economics and Decision Science, University of Sheffield, Sheffield, UK.
Clare
C
Hibbert
Department of Biostatistics and Epidemiology, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
Janos
J
Sandor
Department of Surgical, Anaesthetic and Radiologic Sciences, Section of Anaesthesiology and Intensive Care, University Hospital of Ferrara, Ferrara, Italy.
Maurizia
M
Capuzzo
Faculte de Medicine, Universite Pierre et Marie Curie, Paris, France.
Bertrand R
BR
Guidet
D003625:Data Collection; D005060:Europe; D007362:Intensive Care Units / Q000191:economics*; D012051:Reimbursement Mechanisms