Rethinking the Use of Intensive Care Beds in California Hospitals

Publication Date: March 2007

Publisher: California HealthCare Foundation

Author(s): Cyrus Yang; Charles Cosovich; Jennifer Joynt

Research Area: Health

Type: Brief

Coverage: California

Abstract:

While California is among the states with the lowest overall hospital utilization, studies show that the state's physicians and hospitals use critical care more frequently than their counterparts in other states. This issue brief examining intensive care utilization in California suggests that more efficient use of ICU beds could save hospitals millions of dollars without compromising patient care. It finds that better management would not only reduce hospital operating costs, but improve use of current ICU beds, lead to more efficient utilization of limited nursing resources, and potentially save hundreds of millions of dollars in capital costs. The average cost of a day in the ICU is approximately twice the average for the hospital's non-critical care unit. With Medicare and Medi-Cal often paying flat fees to hospitals regardless of whether patients spend their days in a standard hospital room or the intensive care unit, ICUs are often a source of financial losses for hospitals. Studies have shown that higher utilization often reflects a delivery system in which services are driven not by patient need, but by relative availability of resources. Contrary to concerns that reducing ICU utilization will harm patients, evidence suggests that reducing utilization and improving care are compatible.