ICU cases near top of most costly admissions
Severe respiratory and cardiac conditions account for the largest number of U.S. hospital admissions and contribute significantly to the top rung of the costliest services in health care, according to a new government report.
The findings brought immediate reaction from critical care professionals. If current trends continue, critical care units can expect to see a direct effect on their census, according to Gail Kincaide, executive director of the Association of Women’s Health, Obstetrics, and Neonatal Nurses in Washington, DC.
In fact, premature and low birth weight babies currently surpass the average hospital stay of most patients by more than four to one, according to the federal Agency for Health Care Policy and Research (AHCPR) in Rockville, MD, which issued the latest report. In August, the agency released the latest in a series of statistical reports showing the reasons why Americans are hospitalized, their lengths of stay, the procedures they undergo, and their costs.
According to the report, births represented the most common reason for hospitalization with 3.8 million admissions in 1996, the most recent year of available figures.
Trend isn’t new, expert says
Coronary atherosclerosis ranked second with 1.4 million; followed by pneumonia with 1.2 million; congestive heart failure with 990,000; and heart attack with 774,000 admissions.
The most expensive diagnoses treated in U.S. hospitals included spinal cord injury at $56,800 per patient, followed by infant respiratory distress syndrome at $56,600; low birth weight babies at $50,300; leukemia at $46,700; and heart valve disorders at $45,300. The figures reflect an average charge for the entire stay.
Overall, patients stayed in the hospital an average of five days. But premature and low birth weight cases averaged 23 days, while infant with respiratory distress syndrome averaged 22 days. Spinal cord injury patients recorded a 16-day average. "The rising cost trend isn’t a new issue, but something we’ve noticed for a few years," Kincaide says. Advancements in technology, better outcomes, and poorer lifestyles have helped fuel the increase in patients hospitalized, but have also raised the cost of achieving better patient care.
Better access to medical services coupled with increased prenatal care and better insurance coverage can help lower the need for intensive acute-care admission, according to Kincaide. "We still have a lot to learn about exactly why patients are turning up more acutely ill and requiring critical care services," she says, while calling for additional research into stemming the tide of such admissions.
[Editor’s note: For a copy of the report: contact the Agency for Health Care Policy and Research, Hospital Inpatient Statistics 1996 (AHCPR 99-0034), AHCPR Publications Clearinghouse, P.O. Box 8547, Silver Spring, MD 20907-8547. Telephone: (800) 358-9295.]
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