The Noninvasive Respiratory Care Unit (8)

After accounting for differences in room costs, we believe the remainder of the increased daily costs of the MICU were related to utilization of invasive monitoring and ancillary services. Because our cost summaries did not detail individual service units (procedures, laboratory tests), we were unable to analyze patterns of use for such items. In our experience, patients receive daily tests and services for the duration of their ICU stay. Physicians caring for ICU patients may be reluctant to discontinue monitoring (radiographically, hemodynamically, or biochemically) while the patient remains under “intensive” care. Transfer to the NRCU necessitates re-evaluating and rewriting all medical orders and requires discontinuation of invasive monitoring. This shift in emphasis results in lower daily costs of care.
Were cost reductions in the NRCU associated with compromises in quality of care? While this study was not designed to address this question, survival rates from the NRCU and lengths of hospital stay were consistent with those recorded by others for adults hospitalized with respiratory failure. Moreover, we believe that the NRCU provided a more conducive environment for our patients’ long-term recovery and rehabilitation. When compared to the ICU, the greater privacy, more controlled environment, and less restricted visitor access available in the NRCU may have enhanced weaning and recovery.