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Residents and Fellows Are Cheapest Way to Staff ICUs

Use of non-physician providers is less cost-effective for intensive care units

TUESDAY, Nov. 21 (HealthDay News) -- Using non-physician providers to staff intensive care units is less cost-effective than using residents and fellows, according to the results of a study published in the November issue of the Mayo Clinic Proceedings.

Eric L. Bloomfield, M.D., of the Mayo Clinic College of Medicine in Jacksonville, Fla., and colleagues analyzed data from three Mayo Clinic ICUs: Jacksonville; Rochester, Minn.; and Scottsdale, Ariz. Annual staffing costs were calculated using institutional or national average staff salaries.

The total costs per ICU bed for Rochester, Jacksonville and Scottsdale were $18,630, $37,515 and $38,010, respectively. The Mayo Clinic in Rochester, which had the lowest per-bed costs, also had the highest house-staff to consultant ratio. When house-staff were replaced with non-physician providers, the costs per bed rose to $72,466 in Rochester, $61,291 in Jacksonville and $49,909 in Scottsdale.

"We believe that 24/7 coverage of an ICU with physicians is mandatory for future cost-efficiency and quality of care," the authors conclude. "How to provide such coverage, whether by in-house consultants or at-home consultant coverage, remains to be determined. At teaching hospitals, use of residents and fellows can assist in providing ICU care in a cost-efficient manner."

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