Relationship between availability of physiotherapy services and ICU costs

J Bras Pneumol. 2018 May-Jun;44(3):184-189. doi: 10.1590/S1806-37562017000000196.
[Article in English, Portuguese]

Abstract

Objective: To determine whether 24-h availability of physiotherapy services decreases ICU costs in comparison with the standard 12 h/day availability among patients admitted to the ICU for the first time.

Methods: This was an observational prevalence study involving 815 patients ≥ 18 years of age who had been on invasive mechanical ventilation (IMV) for ≥ 24 h and were discharged from an ICU to a ward at a tertiary teaching hospital in Brazil. The patients were divided into two groups according to h/day availability of physiotherapy services in the ICU: 24 h (PT-24; n = 332); and 12 h (PT-12; n = 483). The data collected included the reasons for hospital and ICU admissions; Acute Physiology and Chronic Health Evaluation II (APACHE II) score; IMV duration, ICU length of stay (ICU-LOS); and Omega score.

Results: The severity of illness was similar in both groups. Round-the-clock availability of physiotherapy services was associated with shorter IMV durations and ICU-LOS, as well as with lower total, medical, and staff costs, in comparison with the standard 12 h/day availability.

Conclusions: In the population studied, total costs and staff costs were lower in the PT-24 group than in the PT-12 group. The h/day availability of physiotherapy services was found to be a significant predictor of ICU costs.

Publication types

  • Observational Study

MeSH terms

  • APACHE
  • Adult
  • Aged
  • Brazil
  • Exercise Therapy / economics*
  • Exercise Therapy / statistics & numerical data
  • Female
  • Health Care Costs
  • Health Services Accessibility / economics*
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Intensive Care Units / economics*
  • Intensive Care Units / statistics & numerical data
  • Length of Stay / economics
  • Length of Stay / statistics & numerical data
  • Linear Models
  • Male
  • Middle Aged
  • Respiration, Artificial / economics
  • Respiration, Artificial / statistics & numerical data
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Time Factors