Economies of scale in British intensive care units and combined intensive care/high dependency units

Intensive Care Med. 2004 Apr;30(4):660-4. doi: 10.1007/s00134-003-2123-2. Epub 2004 Mar 3.


Objective: To estimate the relationship between size of intensive care unit and combined intensive care/high dependency units and average costs per patient day.

Design: Retrospective data analysis. Multiple regression of average costs on critical care unit size, controlling for teaching status, type of unit, occupancy rate and average length of stay.

Setting: Seventy-two United Kingdom adult intensive care and combined intensive care/high dependency units submitting expenditure data for the financial year 2000-2001 as part of the Critical Care National Cost Block Programme.

Interventions: None.

Measurements and results: The main outcome measures were total cost per patient day and the following components: staffing cost, consumables cost and clinical support services costs. Nursing Whole Time Equivalents per patient day were recorded. The unit size variable has a negative and statistically significant ( p<0.05) coefficient in regressions for total, staffing and consumables cost. The predicted average cost for a seven-bed unit is about 96% of that predicted for a six-bed critical care unit.

Conclusion: Policy makers should consider the possibility of economies of scale in planning intensive care and combined intensive care/high dependency units.

MeSH terms

  • Critical Care / economics*
  • Delivery of Health Care / economics
  • Hospital Bed Capacity
  • Hospital Costs / statistics & numerical data*
  • Humans
  • Intensive Care Units / economics*
  • Multivariate Analysis
  • Regression Analysis
  • Retrospective Studies
  • United Kingdom