title: A comparative cost analysis of polytrauma and neurosurgery Intensive Care Units at an apex trauma care facility in India.
abstract: BACKGROUND
  Although Intensive Care Units (ICUs) only account for 10% of the hospital beds, they consume nearly 22% of the hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation.
  
  
  OBJECTIVE
  The aim of this study was to evaluate and compare the cost of intensive care delivery between multispecialty and neurosurgery ICUs at an apex trauma care facility in India.
  
  
  METHODS
  The study was conducted in a polytrauma and neurosurgery ICU at a 203-bedded Level IV trauma care facility in New Delhi, India, from May 1, 2012 to June 30, 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in the study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management.
  
  
  METHODS
  Statistical analysis was performed by Fisher's two tailed t-test.
  
  
  RESULTS
  Total cost/bed/day for the multispecialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU, it was Rs. 14,306.7/-, workforce constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant.
  
  
  CONCLUSIONS
  Quantification of expenditure in running an ICU in a trauma center would assist health-care decision makers in better allocation of resources. Although multispecialty ICUs are more cost-effective, other factors will also play a role in defining the kind of ICU that needs to be designed.
authors.affiliation: Department of Hospital Administration, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Parmeshwar
authors.initials: P
authors.lastname: Kumar
authors.affiliation: Army Medical Corps, Ministry of Defense, Government of India, India.
authors.forename: V
authors.initials: V
authors.lastname: Jithesh
authors.affiliation: Dr. R.P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Shakti Kumar
authors.initials: SK
authors.lastname: Gupta
keywords: Intensive Care Unit; traditional costing method; trauma center