Regionalization of Critical Care Medicine Could Achieve Better Outcomes at Reduced Costs

Research on quality and costs in a regional critical care system

From 1993 to 1995, researchers at IHC Care, an integrated, multi-hospital, nonprofit health care system in Utah, examined the delivery of critical care medicine in a multi-hospital system and developed analytic models to determine the potential impact of regionalization.

Key Findings

  • At IHC, the severity of illness in intensive care units (ICU) is increasing, with implications for hospital costs and length of stay.
  • The larger hospitals within the system are already using an informal system of triage for different levels of critical care, especially in specific disease groups, such as head injuries; however, patient transfer is not always based on severity of illness, for reasons that are not yet understood.
  • Smaller hospitals within the system with very low volumes of ICU patients and lesser severity levels had worse patient outcomes than other facilities.
  • Reorganizing critical care could be a major factor in improving care for critically ill patients at IHC.
  • Improving the process of health care delivery influences outcomes in an intensive care unit favorably, while dramatically lowering costs.

Funding

The Robert Wood Johnson Foundation (RWJF) supported this project through a grant of $396,561.

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