"Because of the wide range of life threatening illnesses treated in intensive care, it has been a difficult area for managed care organisations and performance improvement staff to measure. Hence, cost-cutting efforts generally have been avoided", stated Jean Chenoweth, executive director of the Solucient Leadership Institute. "However, this study shows that the pay off for improving quality of care and reducing costs is enormous for everyone, including the patients, the hospitals and the payors."
"ICUs account for ten percent of hospital patient beds but twenty-five percent of a hospital's cost structure", explained Mike Breslow, M.D., executive vice president of Baltimore-based VISICU, which sponsored the study. "The ICU is where patients are dying and where health care is spending huge amounts of money, so it is critical to assess what hospitals can do differently." U.S. hospitals treat about 5 million ICU patients a year, a number expected to double during the next fifteen years as the population ages, according to Dr. Breslow, a specialist trained in intensive care at Johns-Hopkins before co-founding VISICU.
"The research shows that regardless of whether we are comparing teaching hospitals, teaching hospitals with residencies in intensive care, or community hospitals, some institutions in all three categories exhibit superior intensive care management, resulting in much better outcomes and significantly lower costs", Mrs. Chenoweth commented. "We hope the development of these benchmarks and naming the top performing ICU hospitals will encourage others to study those winning ICU practices."
The study analysed three different sets of patient populations, including those with at least one of 10 medical diagnoses which commonly result in an ICU admission, such as heart attack or stroke; surgical procedures that are commonly admitted to an ICU post-operatively, like lung removal or open heart; and ICU admissions in which the patients were on a life-supporting mechanical ventilator for four or more days. Only hospitals with 30 or more cases in each patient population, a universe of 1200 hospitals, were included in the study. For each group, all performance measurements were adjusted to include factors which impact mortality independent of the ICU. Data sources for the study included publicly available 1998 and 1999 MedPAR data, which covers nearly 6000 hospitals.
VISICU Inc. in Baltimore, Maryland, is the "ICU Company" and through its innovative Continuous Expert Care Network (CXCN), is forging a new standard for critical care delivery by combining advanced technologies and comprehensive clinical services. VISICU provides ICU patients with around-the-clock care from an off-site electronic ICU "eICU", staffed by trained intensive care specialists, called "intensivists", and critical care nurses. CXCN combines this staff with telemedicine, clinical information systems, decision support tools, and outcomes tracking software into a powerful programme enabling the hospitals to save lives, improve outcomes, and reduce costs.
The result of a recent merger of HCIA-Sachs with HBSI, Solucient, located in Illinois, powers health care decision-making. As the largest source of health care intelligence and benchmark information, Solucient provides health care organisations with access to comprehensive, results-oriented information to grow their business, contain costs and deliver quality care. Solucient delivers strategic clinical, operational, financial, planning and marketing information resulting in improved health care business and clinical outcomes. As such, Solucient's robust information helps benchmark performance across the continuum of care.
The Solucient Leadership Institute is the research and education division of Solucient and dedicated to the improvement of the health care industry through the promulgation of quality information. The Institute provides 100 Top Hospitals as well as Clinical Research Programme studies. Study excerpts are available via the Internet at the 100 Top Hospitals site.