by Michael Wong
According to study recently published in Anesthesiology News, Riley Hospital for Children at Indiana University Health spent about $112,000 and saved $985,130 over a six month period. Dr. Courtney Rowan, pediatric critical care fellow at Riley Hospital, was looking at blood gas measurements.
Blood gases measures “how much oxygen and carbon dioxide is in your blood”. Accordingly, as stated in the Approved Guidelines for blood gas and pH analysis and related measurements, “no other test results have more immediate impact on patient care.”
However, with importance comes frequency, particularly in treating critical care patients and taking blood gas measurements. For example, the Surgical Intensive Care of Geneva University Hospital reported that in one year they performed 46,000 blood gas analyses. The frequency of this analyses naturally increases patient care costs. As researchers at Geneva University Hospital explain, “Expenditure due to laboratory testing increases continuously and represents up to 25% of the cost of caring for patients in intensive care units.”
Controlling that cost, without sacrificing patient safety, is important, particularly as reducing healthcare costs is a concern for health care facilities. Consequently, Dr. Rowan’s study is significant for demonstrating how to decrease costs while improving patient safety.
According to Dr. Rowan, after continuously monitoring all mechanically ventilated patients in pediatric ICU a month after the hospital began continuous capnography of all patients, to the same time period in 2010, the average number of blood gas measurements per encounter decreased from 21.6 to 13.8, and such measurements per ventilator-day also declined from 4.7 to 3.3. The retrospective study showed the number of blood gas measurements declined from 13,171 to 8,070, resulting in a total cost savings of almost $1 million over a 6-month period.
Moreover, as Dr. Rowan tells me:
The money you save is a nice bonus, but we use capnography mainly because it’s the right thing to do for patients.
What do you think — is Dr. Rowan’s study just limited to ICU patients or does it have broader implications for the general floor?
good study with broad application. Nowadays, we need more studies to show how to decrease health costs without compromising patient safety.
One physician reader emailed this comment: Given our national health statistics being average for a developed country and our health care financial costs being twice any other developed country I would think that any rational person would have to conclude that there must be financial cost savings within our health care system even with a 25% administrative cost structure.
What do you think?