Costs and cost-effectiveness of a telemedicine intensive care unit program in 6 intensive care units in a large health care system

• Published in: Journal of critical care Vol. 26; no. 3; pp. 329.e1 - 329.e6
• Main Authors: Franzini, Luisa, PhD, Sail, Kavita R., PhD, Thomas, Eric J., MD, MPH, Wueste, Laura, RN, MSN
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2011; Elsevier Limited
• Subjects: Cost-Benefit Analysis; Critical Care; Economic analysis; Hospital Costs - statistics & numerical data; Humans; Intensive care; Intensive care units; Intensive Care Units - economics; Mortality; Physicians; Program Evaluation; Severity of Illness Index; Studies; Telemedicine; Telemedicine - economics; Telemedicine; Economic analysis; Intensive care units
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2010.12.004

Abstract Purpose The purpose of this study is to estimate the costs and cost-effectiveness of a telemedicine intensive care unit (ICU) (tele-ICU) program. Materials and Methods We used an observational study with ICU patients cared for during the pre–tele-ICU period and ICU patients cared for during the post–tele-ICU period in 6 ICUs at 5 hospitals that are part of a large nonprofit health care system in the Gulf Coast region. We obtained data on a sample of 4142 ICU patients: 2034 in the pre–tele-ICU period and 2108 in the post–tele-ICU period. Economic outcomes were hospital costs, ICU costs and floor costs, measured for average daily costs, costs per case, and costs per patient. Results After the implementation of the tele-ICU, the hospital daily cost increased from $4302 to $5340 (24%); the hospital cost per case, from $21 967 to $31 318 (43%); and the cost per patient, from $20 231 to $25 846 (28%). Although the tele-ICU intervention was not cost-effective in patients with Simplified Acute Physiology Score II 50 or less, it was cost-effective in the sickest patients with Simplified Acute Physiology Score II more than 50 (17% of patients) because it decreased hospital mortality without increasing costs significantly. Conclusions Hospital administrators may conclude that a tele-ICU program aimed at the sickest patients is cost-effective.