FULL-COST DETERMINATION OF DIFFERENT LEVELS OF CARE IN THE INTENSIVE-CARE UNIT - AN ACTIVITY-BASED COSTING APPROACH

We applied an activity-based costing methodology to determine the full cost of intensive care service at a community hospital, a university hospital and a health maintenance organisation (HMO)-affiliated hospit al. A total of 5 patient care units were analysed: the intensive care unit (ICU) and surgical ICU (SICU) at the university setting, the ICU at the community setting, and the SICU and cardiac care unit at the HM O setting. The selection of the different ICU types was based on the t ypes of critical care units that were found in each setting (e.g. the HMO did not have an ICU). institution-specific cost data and clinical management parameters were collected through surveys and site visits f rom the 3 respective organisation types. The analysis revealed a marke d increase in patient-minute cost associated with mechanical ventilati on. Higher costs associated with prolonged neuromuscular blockade have important economic implications with respect to selection of an appro priate neuromuscular blocking agent.