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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2001 January-February;67(1-2):41-53

language: Italian

Cost of ICU in Italy. Results from an empirical study on a sample of 12 hospitals

Cavallo M. C., Lazzaro C., Tabacchi M., Langer M. *, Salvo I. **, Serra G. ***, Taddei C. ***

CeRGAS Università «L. Bocconi» - Milano
*Ospedale «S. Matteo» IRCCS - Pavia Anestesia e Rianimazione II
**Ospedale «V. Buzzi» - Milano Servizio di Anestesia e Rianimazione
***Pharmacoeconomics Department Smithkline Beecham SpA


Background. The Italian hos­pi­tal pay­ment ­system ­based on DRG ­doesn’t prop­er­ly ­include Intensive Care Units (ICU) ­costs. Since ­great empha­sis has ­been recent­ly giv­en to ration­ing ­health ­care resourc­es, assess­ing ICU ­costs ­seems to be dra­mat­i­cal­ly rel­e­vant. Aim of the ­study was to ­assess the aver­age year­ly ­cost and the ­cost per ­diem of a sam­ple of Italian mul­ti­spe­cia­lis­tic ICU ­wards.
Methods. In September 1995, a ques­tion­naire con­cern­ing ­data on var­i­able and ­fixed ­cost was ­sent to 25 Italian ICU ­wards, 11 NHS hos­pi­tal-­based (Northern Italy: 5; Central Italy: 4; Southern Italy: 2) and 14 ­school of med­i­cine-­based (Northern Italy: 7; Central Italy: 5; Southern Italy: 2). Variable ­cost ­data includ­ed: dis­pos­able, ­drugs, ­blood and ­blood-­derived prod­ucts, phys­i­cal ­tests, chem­i­cal and micro­bi­o­log­i­cal rou­tines, instru­men­tal diag­nos­tic pro­ce­dures and phys­io­ther­a­py. Concerning ­fixed ­costs, ­data on per­son­nel and equip­ment ­were request­ed. In addi­tion, ­some hos­pi­tal over­heads ­data (util­ities; pow­er; heat­ing; main­te­nance; clean­ing; laun­dry; account­ing; ­waste dis­po­sal; caf­e­te­ria) ­were col­lect­ed.
Results. On the ­basis of the 12 ques­tion­naires ­returned (Northern Italy: 9; Central Italy: 3; Southern Italy: 0), the year­ly ­cost of an ICU ­ward is Liras 4,580,032,000 (­range 2,739,277,000-7,704,292,000), where­as the aver­age ­cost per ­diem is Liras 1,802,000 (­range 1,234,000-3,179,000). Cost of per­son­nel is ­about 61% of the ­above men­tioned ­costs.
Conclusions. Despite the ­lack of ques­tion­naires ­from Southern Italy and the unavail­abil­ity of ­some ­data con­cern­ing ­both the ­cost of equip­ment and the over­heads, the remark­able aver­age ­cost val­ues ­obtained ­could sup­port fur­ther ­research.

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