Format

Send to

Choose Destination
See comment in PubMed Commons below
Pediatrics. 2014 Aug;134(2):235-41. doi: 10.1542/peds.2014-0140.

Cost-benefit analysis of a medical emergency team in a children's hospital.

Author information

  • 1Division of General Pediatrics,Departments of Pediatrics,Center for Pediatric Clinical Effectiveness,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania; and bonafide@email.chop.edu.
  • 2Biostatistics and Epidemiology, and.
  • 3Center for Pediatric Clinical Effectiveness.
  • 4Departments of Nursing.
  • 5Anesthesiology and Critical Care Medicine, andAnesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania;
  • 6Division of General Pediatrics.
  • 7Finance, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania;
  • 8Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
  • 9Division of General Pediatrics,Departments of Pediatrics,Center for Pediatric Clinical Effectiveness,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania; and.

Abstract

OBJECTIVES:

Medical emergency teams (METs) can reduce adverse events in hospitalized children. We aimed to model the financial costs and benefits of operating an MET and determine the annual reduction in critical deterioration (CD) events required to offset MET costs.

METHODS:

We performed a single-center cohort study between July 1, 2007 and March 31, 2012 to determine the cost of CD events (unplanned transfers to the ICU with mechanical ventilation or vasopressors in the 12 hours after transfer) as compared with transfers to the ICU without CD. We then performed a cost-benefit analysis evaluating varying MET compositions and staffing models (freestanding or concurrent responsibilities) on the annual reduction in CD events needed to offset MET costs.

RESULTS:

Patients who had CD cost $99,773 (95% confidence interval, $69,431 to $130,116; P < .001) more during their post-event hospital stay than transfers to the ICU that did not meet CD criteria. Annual MET operating costs ranged from $287,145 for a nurse and respiratory therapist team with concurrent responsibilities to $2,358,112 for a nurse, respiratory therapist, and ICU attending physician freestanding team. In base-case analysis, a nurse, respiratory therapist, and ICU fellow team with concurrent responsibilities cost $350,698 per year, equivalent to a reduction of 3.5 CD events.

CONCLUSIONS:

CD is expensive. The costs of operating a MET can plausibly be recouped with a modest reduction in CD events. Hospitals reimbursed with bundled payments could achieve real financial savings by reducing CD with an MET.

Copyright © 2014 by the American Academy of Pediatrics.

KEYWORDS:

Patient Protection and Affordable Care Act; cost-benefit analysis; health care financing; hospital rapid response team; intensive care units

[PubMed - indexed for MEDLINE]
Free full text
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire
    Loading ...
    Write to the Help Desk