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Study: Early PT in ICU saves money
Thursday February 14, 2013

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In a study evaluating the financial impact of providing early physical therapy for ICU patients, researchers found the upfront costs were outweighed by the financial savings generated by earlier transfers out of the ICU and shorter hospital stays overall.

"The evidence is growing that providing early physical and occupational therapy for intensive care patients — even when they are on life support — leads to better outcomes," Dale M. Needham, MD, PhD, the study’s senior author and an associate professor of medicine and a critical care specialist at Johns Hopkins University School of Medicine in Baltimore, said in a news release.

Needham said a major barrier to early rehab programs in the ICU has been concern among hospital administrators about the cost. "However, our study shows that a relatively low investment upfront can produce a significant overall reduction in the cost of hospital care for these patients."

For the study, scheduled for publication in the March issue of the journal Critical Care Medicine, the researchers developed a financial model based on outcomes in The Johns Hopkins Hospital’s medical ICU and on projections for hospitals of different sizes with variable lengths of stay.

The Johns Hopkins MICU admits about 900 patients a year. In 2008, the hospital created an early rehabilitation program with dedicated physical and occupational therapists, adding about $358,000 to the annual cost of care. But by 2009, the length of stay in the MICU had decreased by an average of 23%, down from six-and-a-half days to five days, while the time spent by those patients in step-down units fell 18%. Using their financial model, the authors estimated a net cost saving for the hospital of about $818,000 a year.

The researchers then analyzed the potential affect of early rehabilitation services in 24 scenarios based on hospital size and length of stay, accounting for variations in the number of ICU admissions, cost savings per day, and reductions in length of stay.

Needham said the financial model can serve as a resource for hospitals throughout the U.S. to estimate their own net cost for providing early physical rehabilitation to ICU patients. He said length of stay is the biggest driver of cost to a hospital, which typically gets paid a fixed amount for caring for patients with specific diagnoses.

Needham concluded, "More patients are surviving their ICU stay than ever before, yet many lose muscle strength during treatment for a critical illness because of long periods of bed rest." Early rehabilitation therapy, he said, can prevent muscle weakness that impairs patients’ ability to care for themselves after discharge.


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Thursday February 14, 2013
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