INTENSIVE-CARE COSTING METHODOLOGY - COST-BENEFIT-ANALYSIS OF MASK CONTINUOUS POSITIVE AIRWAY PRESSURE FOR SEVERE CARDIOGENIC PULMONARY-EDEMA

Costing data for intensive care admissions is important, not only for unit funding, but also for cost outcome analysis of new therapies. Thi s paper presents an intensive care episode costing methodology using t he example of a cost-benefit analysis of mask CPAP for severe cardioge nic pulmonary oedema (CPO). This analysis examines the intervention of admitting all patients with severe CPO to the intensive care unit for mask CPAP, compared with the previous practice of admitting only pati ents failing conventional non-CPAP treatment and requiring mechanical ventilation. The episode costs were determined from a prospective stud y which showed mask CPAP reduced the need for mechanical ventilation f rom 35% to 0%. The mean cost of a mask CPAP episode was $1,156, with a mean stay of 1.2 days, compared with ventilated patients, $5,055 and 4.2 days. The major contributors to cost in both groups were nursing a nd medical salaries, and hospital overheads. The cost of previous esti mated yearly caseload of 35 ventilated patients ($176,925) was greater than the cost associated with an increased caseload of 100 mask CPAP patients ($115,600). We conclude that, despite an increase in admissio ns, mask CPAP for severe CPO is cost-effective.