Two years ago, we described a specialized unit, designated the noninvasive respiratory care unit (NRCU), at our medical center. The unit was established in 1981 and extensively restructured in 1986 based on our belief that caring for selected patients in the NRCU was a cost-effective alternative to caring
for patients in the intensive care unit (ICU). Several studies have demonstrated that institutional costs for providing care to ventilator-dependent patients are high and often far exceed payments. With the increasing utilization of ventilator support, management of patients requiring mechanical ventilation has become a fiscal as well as a medical concern. In this article, we describe the types of patients cared for in our NRCU and the financial impact of the NRCU on our institution.
Unit Description
The NRCU is an 11-bed unit with the capacity to care for eight patients receiving continuous mechanical ventilation. The NRCU is located on one of our general medical units. The private rooms comprising the NRCU were modified to accommodate the needs of our patient population. These modifications included upgrading of the electrical system; installing a rail system to accommodate respiratory equipment, supplies, and gases; and installing surveillance cameras and bedside ECC monitors. Room charges, however, are billed at the standard rate for a private general medical bed.