Determining the Cost and Length of Stay at Intensive Care Units and the Factors Influencing Them in a Teaching Hospital in Malaysia.
OBJECTIVES
Escalating healthcare costs calls for the efficiency of health services, especially in the intensive care unit (ICU) where the bulk of resources are used. This study aims to identify the length of stay (LOS) and cost of care at ICUs, which are proxy indicators of efficiency and the factors determining them.


METHODS
A cross-sectional study of patients requiring ICU admissions in a teaching hospital in Malaysia from 2013 to 2015 was conducted. The cost at the ICU was estimated using the step down approach. Factors that determined the cost and LOS at the ICU were also explored by using multivariate regression analysis.


RESULTS
Each day of stay cost $427 (USD) at the pediatric intensive care unit and $1324 at the general intensive care unit. The mean LOS at the ICU was 5.7 days (standard deviation [SD]: 8.4) with a median of 4 days (95% confidence interval [CI] 1-16.7 days). Average cost of care at the ICU per episode of care was $5473 (SD $6499), and the median was $3463. ICU patients spent 29.3% of the total stay and 47.2% of the cost at ICU units. Upon multivariate regression analysis, severity, case base-group, and type of ICU that the patient was admitted to were associated with the cost and LOS at ICU.


CONCLUSIONS
Compared with critical care practices in hospitals from more developed nations, a Malaysian teaching hospital required a longer length of ICU stay. Hence, implementations of strategies that can reduce the length of stay and hospital costs without compromising healthcare quality are required.
['Aung|Yin Nwe|YN|', 'Nur|Amrizal M|AM|', 'Ismail|Aniza|A|', 'Aljunid|Syed M|SM|']
D000328:Adult D000368:Aged D003430:Cross-Sectional Studies D005260:Female D017048:Health Care Costs D006784:Hospitals, Teaching D006801:Humans D007362:Intensive Care Units D007902:Length of Stay D008296:Malaysia D008297:Male D008875:Middle Aged
determinants cost length of stay Malaysia ICU casemix