Estimation of direct cost and resource allocation in intensive care: correlation with Omega system

Objective: Many hospitals were unprepared for the surge of patients associated with the spread of coronavirus disease 2019 (COVID-19) pandemic. We describe the processes to develop and implement a surge plan framework for resource allocation, staffing, and standardized management in response to the COVID-19 pandemic across a large integrated regional healthcare system.Setting: A large academic medical center in the Cleveland metropolitan area, with a network of 10 regional hospitals throughout Northeastern Ohio with a daily capacity of more than 500 intensive care unit (ICU) beds.Results: At the beginning of the pandemic, an equitable delivery of healthcare services across the healthcare system was developed. This distribution of resources was implemented with the potential needs and resources of the individual ICUs in mind, and epidemiologic predictions of virus transmissibility. We describe the processes to develop and implement a surge plan framework for resource allocation, staffing, and standardized management in response to the COVID-19 pandemic across a large integrated regional healthcare system. We also describe an additional level of surge capacity, which is available to well-integrated institutions called “extension of capacity.” This refers to the ability to immediately have access to the beds and resources within a hospital system with minimal administrative burden.Conclusions: Large integrated hospital systems may have an advantage over individual hospitals because they can shift supplies among regional partners, which may lead to faster mobilization of resources, rather than depending on local and national governments. The pandemic response of our healthcare system highlights these benefits.

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Resource Allocation in the Intensive Care Unit

Textbook of Critical Care ◽

10.1016/b978-1-4377-1367-1.00215-9 ◽

2011 ◽

pp. 1568-1572

Author(s):

Gordon D. Rubenfeld

Keyword(s):

Intensive Care Unit ◽

Resource Allocation ◽

Intensive Care

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Student nurses’ ethical views on responses to the severe acute respiratory syndrome outbreak

Nursing Ethics ◽

10.1177/0969733019895804 ◽

2020 ◽

Vol 27 (4) ◽

pp. 924-934

Author(s):

Joseph KM Kam ◽

Eric Chan ◽

Albert Lee ◽

Vivian WI Wei ◽

Kin On Kwok ◽

...

Keyword(s):

Intensive Care Unit ◽

Resource Allocation ◽

Intensive Care ◽

Nursing Students ◽

Severe Acute Respiratory Syndrome ◽

Infectious Diseases ◽

Health Workers ◽

Intensive Care Unit Care ◽

Central Research ◽

Collateral Damage

Background Fifteen years have passed since the outbreak of severe acute respiratory syndrome in Hong Kong. At that time, there were reports of heroic acts among professionals who cared for these patients, whose bravery and professionalism were highly praised. However, there are concerns about changes in new generation of nursing professionals. Objective We aimed to examine the attitude of nursing students, should they be faced with severe acute respiratory syndrome patients during their future work. Research design A questionnaire survey was carried out to examine the attitude among final-year nursing students to three ethical areas, namely, duty of care, resource allocation, and collateral damage. Ethical considerations This study was carried out in accordance with the requirements and recommendations of the Central Research and Ethics Committee, School of Health Sciences at Caritas Institute of Higher Education. Findings Complete responses from 102 subjects were analyzed. The overwhelming majority (96.1%) did not agree to participate in the intubation of severe acute respiratory syndrome patients if protective measures, that is, N95 mask and gown, were not available. If there were insufficient N95 masks for all the medical, nursing, and allied health workers in the hospital (resource allocation), 37.3% felt that the distribution of N95 masks should be by casting lot, while the rest disagreed. When asked about collateral damage, more than three-quarters (77.5%) said that severe acute respiratory syndrome patients should be admitted to intensive care unit. There was sex difference in nursing students’ attitude toward severe acute respiratory syndrome care during pregnancy and influence of age in understanding intensive care unit care for these patients. Interestingly, 94.1% felt that there should be a separate intensive care unit for severe acute respiratory syndrome patients. Conclusion As infection control practice and isolation facilities improved over the years, relevant knowledge and nursing ethical issues related to infectious diseases should become part of nursing education and training programs, especially in preparation for outbreaks of infectious diseases or distress.

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Predictors and Direct Cost Estimation of Long Stays in Pediatric Intensive Care Units in Saudi Arabia: A Mixed Methods Study

Risk Management and Healthcare Policy ◽

10.2147/rmhp.s311100 ◽

2021 ◽

Vol Volume 14 ◽

pp. 2625-2636

Author(s):

Mohamad-Hani Temsah ◽

Noura Abouammoh ◽

Ayman Al-Eyadhy ◽

Yazed AlRuthia ◽

Marwah Hassounah ◽

...

Keyword(s):

Saudi Arabia ◽

Intensive Care ◽

Mixed Methods ◽

Intensive Care Units ◽

Direct Cost ◽

Cost Estimation ◽

Pediatric Intensive Care ◽

Mixed Methods Study ◽

Pediatric Intensive Care Units

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Recognition of Neonatal Hospitalization Cost in an Intensive Care Unit in Greece and the Deviation from Its Current Reimbursement System

Studies in Health Technology and Informatics - Public Health and Informatics ◽

10.3233/shti210128 ◽

2021 ◽

Author(s):

Antonia Christoforidou ◽

Charalambos Platis ◽

Emmanouil Zoulias ◽

Giannis Karafyllis

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Health Services ◽

Direct Cost ◽

Reimbursement System ◽

Real Cost ◽

Care Services ◽

Quality Health ◽

Duration Of Hospitalization ◽

The Cost

In this paper efforts have been made to record the actual, real cost of health care services in a Neonatal Intensive Care Unit (N.I.C.U.) of a public hospital. It is well known that, in recent years, the hospitals have been reimbursed with the system of Diagnosis-Related Groups (D.R.G.’s). The purpose of this study is to determine whether the costs according with D.R.G.’s correspond to the actual-real cost, as this is recorded in the N.I.C.U. This cost is called direct cost. Here is a case study of a premature neonate in the intensive care unit (N.I.C.U.). From the outset, the age of pregnancy, the birth weight, the duration of hospitalization in N.I.C.U. and the needs of the newborn in oxygen, medication, as well as nutrition are defined which are very important in shaping the cost. Then, the cost is calculated according to the D.R.G.’s system. By setting three basic diagnoses (I.C.D.-10), we find the D.R.G. which better describes the case, as well as the associated costs. Then, we calculate the direct cost and list all the consumables, exams, staff costs, overheads. Comparing the two results we find that the cost of D.R.G. does not meet the direct cost of hospitalization. There is a significant deviation from the actual real cost, which proves the under-costing of the health services. The D.R.G.’s system leads hospitals to increase their financial deficits and provide degraded quality health services. It is necessary to readjust the D.R.G.’s according to the reality and the redefinition of the hospital’s reimbursement system to meet the direct – real cost of the health services offered.

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