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Individual Physicians Influence Cost of Intensive Care

But intensivists' identity does not affect length of ICU stay or hospital mortality

FRIDAY, Dec. 1 (HealthDay News) -- The cost of intensive care varies as much as 43 percent depending on the clinician who treats patients, researchers report in the Dec. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

Allan Garland, M.D., of MetroHealth Medical Center in Cleveland, Ohio, and colleagues studied the cost of critical care associated with nine physicians treating 1,184 patients over a period between July 2002 and March 2005 in one intensive care unit (ICU).

The researchers found that individual physicians had a greater effect on average daily costs than other variables except illness type and severity. The costs varied by 43 percent or $1,003 per admission from the highest third to the lowest. Physicians' identity did not forecast intensive care stay length or in-hospital death.

"Higher spending intensivists did not generate better outcomes than their lower-spending colleagues," the authors write. "It appears possible to reduce ICU costs without worsening outcomes if we can alter physicians' practice styles."

In an editorial, Jeremy Kahn, M.D., of the University of Pennsylvania School of Medicine in Philadelphia, and a colleague write that "cost control is not just the task of the health policy expert or the hospital administrator -- it is also the task of the individual ICU clinician."

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