Lacking data that directly compares the NRCU and the MICU, we utilized the NRCU as an intermediate care unit for early transfer out of the MICU, not as a replacement for the MICU. The cost savings resulting from shorter ICU stays are particularly important given our payor mix, which is heavily weighted toward Medicare patients.
Conclusions
Providing intensive care for Medicare and Medicaid recipients who require long-term ventilator support is financially draining to hospitals. Appreciation for the high costs and limited outcomes of intensive care has prompted investigation of other care delivery systems that could provide quality care at a more reasonable cost. We have found the NRCU to be an important advance toward this goal. We have demonstrated that substantial cost reductions can be realized by expediting the transfer of selected patients out of the ICU to the NRCU. The NRCU has enhanced our ability to provide care that is clinically effective and economically sound. It may be an appropriate model for other institutions with similar patient populations.