ICU early rehabilitation programs saves money

Investment in an intensive care unit early rehabilitation program can save money for US hospitals even under the most conservative assumptions, according to a recently published study.

Researchers developed a model of net financial savings/costs using data from existing publications and actual experience with an early rehabilitation program at the Johns Hopkins Hospitals Medical intensive care unit (ICU). Accounting for both conservative- and best-case scenarios, results were presented for ICUs with 200, 600, 900 and 2,000 annual admissions.

In the researchers’ example scenario from the Johns Hopkins Medical ICU early rehabilitation program with 900 annual admissions and actual length of stay reduction of 22% in the ICU and 19% on the floor, generated net cost savings were $817,836. Researchers also found financial projections ranging from -$87,611 in net cost to $3,763,149 in net savings across ICUs with 200 to 2,000 annual admissions, using conservative- and best-case scenarios for length of stay reduction and varied and per-day ICU and floor costs.

Twenty of the 24 scenarios included in these analyses demonstrated net savings by providing early rehabilitation to their ICU patients. Only a relatively small net cost occurred in the remaining scenarios, mostly when simultaneously combining the most conservative assumptions.

“The bottom line is that early rehabilitation in the ICU helps patients play an active role in their recovery and can make a big difference in their quality of life when they leave the hospital,” Dale M. Needham, MD, PhD, an associated professor of medicine and critical care specialist at the Johns Hopkins University School of Medicine, stated. “More patients are surviving their ICU stay than ever before, yet many lose muscle strength during treatment for a critical illness because of long periods of bed rest. Such programs are an example of how we can save money and improve care at the same time.”

Lord, RK. Critical Medical Care. 2013;doi:10.1097/CCM.0b013e3182711de2.

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