Variable Costs of the Intensive Care Units and its Determinants in Iranian Hospitals

• Main Authors: Mohammad Fathi, Nader Markazi Moghaddam, Zahra Meshkani, Ali Kazemi Karyani
• Format: Article
• Language: English
• Published: Shahid Sadoughi University of Medical Sciences 2020-03-01
• Series: Journal of Evidence Based Health Policy, Management & Economics
• Subjects: hospitals; icu; cost analysis; hospital costs
• Online Access: http://jebhpme.ssu.ac.ir/article-1-264-en.html

Background:  Managers can avoid waste in resources and provide valuable insight by studying the variables associated with the costs in the intensive care units (ICU). The aim of this study was to evaluate the variable costs of ICUs and factors that contribute to cost structure in Iran. Methods: A retrospective micro-costing method was performed on 468 admissions with a length of stay ≥ 24 hours in ICUs in a university hospital in 2017. The variable costs were consumables, laboratory tests, and medicines. The IBM SPSS24software was used to analyze the data. Results: The variable costs per ICU day and patient were $94.14 and $1,309, respectively, and the total variable cost was $612,641. The costs for consumables, laboratory tests, and medicine were responsible for 19 %, 27 %, and 54 % of the variable costs, respectively. The average variable costs for non-survivors were 2.5 times higher than the other variables. Medicine was the key driver of costs in all ICUs. Overall, antibiotics, blood derivatives, blood biochemistry, blood group & Rh, cutter, and tracheal intubation had the highest costs. Conclusion: To reduce the costs, national standard treatment guidelines and essential medicine lists based on treatments of the choice should be revised. Patients who are in the final stages of a terminal illness can continue their treatment at home-based care or alternative cares such as palliative to reduce the hospital costs.