Analysis of consultations requested from the tertiary intensive care unit and response times: a retrospective study

Yıl 2023, , 919 - 924, 28.09.2023

Mehmet Çağatay Gürkök , Ozlemoner Öner , Ferhan Demirer Aydemir , Özge Kuzgun , Alkan Durmuş , Sabri Erdem Necati Gökmen

https://doi.org/10.32322/jhsm.1316989

Öz

Aims: It is aimed to evaluate the effectiveness of the consultations and response times requested from the Intensive Care Unit on the cost.
Methods: This study was conducted retrospectively in a 16-bed anesthesia intensive care unit (ICU) between 02.01.2019 and 30.12.2019. Patient information from the hospital data system was analyzed. Accordingly, demographic data, hospitalization diagnoses, departments for which consultation was requested, times of request, response times, and the average cost per day of a patient were investigated.
Results: It was determined that consultation was requested from a total of 522 patients, 223 (43%) of the patients were female, 299 (57%) were male, and the age range was 18-98 (mean age 57). It was found that the average consultation response time in all departments was 4.09 hours outside of working hours and 3.54 hours during working hours. There was no significant difference in the response time of consultations between internal and surgical departments. The daily cost of one patient in the ICU was found to be 2380.39 ₺.
Conclusion: Failure to promptly respond to the requested consultations in the intensive care unit may cause delays in patients' treatment and their discharge to the service. This situation increases the patient's length of stay and causes the intensive care units not to be used effectively and correctly. However, it can also increase morbidity and cost.

Anahtar Kelimeler

Intensive care unit, consultation, response time, morbidity, cost

Kaynakça

• Aygencel G, Türkoglu M. Characteristics, outcomes and costs of prolonged stay ICU patients/yogun bakimda uzun yatan hastalarin özellikleri, sonuçları ve maliyetleri. Dahili ve Cerrahi Bilimler Yogun Bakim Derg. 2011;2(3):53.
• Nice N. Acutely ill patients in hospital. NHS; 2007.
• Luce JM, Rubenfeld GD. Can health care costs be reduced by limiting intensive care at the end of life? Am J Respir Crit Care Med. 2002;165(6):750-
• TCSSYB Yataklı Sağlık Tesislerinde Yoğun Bakım Hizmetlerinin Uygulama Usul ve Esasları Hakkında Tebliğ, Ekler: 29.05.2013 Tebliğ Ekleri. 2013.
• Priestap FA, Martin CM. Impact of intensive care unit discharge time on patient outcome. Crit Care Med. 2006;34(12):2946-51.
• Medicine FoIC. Guidelines for the provision of intensive care services version 2. FICM London; 2019.
• Dokuz Eylül Üniversitesi Tıp Fakültesi Konsültasyon Prosedürü. 2017.
• Jordan MR, Conley J, Ghali WA. Consultation patterns and clinical correlates of consultation in a tertiary care setting. BMC Res Notes. 2008;1(1):1-6.
• Mittal MK, Kashyap R, Herasevich V, Rabinstein AA, Wijdicks EF. Do patients in a medical or surgical ICU benefit from a neurologic consultation? Int J Neurosci. 2015;125(7):512-20.
• Dugar S, Choudhary C, Duggal A. Sepsis and septic shock: Guideline-based management. Cleveland Clin J Med. 2020;87(1): 53-64.
• Schouten J, De Angelis G, De Waele J. A microbiologist consultant should attend daily ICU rounds. Springer; 2020.
• Salinas M, López-Garrigós M, Asencio A, et al. Alert value reporting: a new strategy for patient safety. Clin Biochem. 2013;46(3):245-9.
• Yataklı Tedavi Kurumları Enfeksiyon Kontrol Yönetmeliği: Resmi Gazete; 2005 [Available from: resmigazete.gov.tr/eskiler/2005/08/20050811-6.htm.
• Peris A, Bonizzoli M, Iozzelli D, et al. Early intra-intensive care unit psychological intervention promotes recovery from post traumatic stress disorders, anxiety and depression symptoms in critically ill patients. Crit Care. 2011;15(1):1-8.
• Tiruvoipati R, Botha J, Fletcher J. Australia and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group. Intensive care discharge delay is associated with increased hospital length of stay: a multicentre prospective observational study. PLoS One. 2017;12(7):e0181827.
• Van der Sluijs AF, Van Slobbe-Bijlsma ER, Chick SE, et al. The impact of changes in intensive care organization on patient outcome and cost-effectiveness—a narrative review. J Intens Care. 2017;5(1):1-8.
• Toptas M, Sengul Samanci N, Akkoc İ, et al. Factors affecting the length of stay in the intensive care unit: our clinical experience. BioMed Res Int. 2018;2018.
• Norris C, Jacobs P, Rapoport J, Hamilton S. ICU and non-ICU cost per day. Can J Anaesth. 1995;42(3):192-6.
• Yıldız E, Tokur ME, Özlem Ö, Aydın T. Hastaların yoğun bakım ünitelerinden taburcu edilememe nedenleri ve maliyeti. Mustafa Kemal Üniversitesi Tıp Derg. 10(38):88-93.
• Karabatsou D, Tsironi M, Tsigou E, et al. Variable cost of ICU care, a micro-costing analysis. Intensive Crit Care Nurs. 2016;35:66-73.
• Dasta JF, McLaughlin TP, Mody SH, Piech CT. Daily cost of an intensive care unit day: the contribution of mechanical ventilation. Crit Care Med. 2005;33(6):1266-71.
• Lefrant JY, Garrigues B, Pribil C, et al. The daily cost of ICU patients: a micro-costing study in 23 French intensive care units. 2015;34(3):151-157. Doi: 10.1016/j.accpm.2014.09.004