The hidden costs of treating severely ill patients: charges and resource consumption in an intensive care unit.

A detailed survey of the resources used by two common groups of intensive care unit (ICU) admissions in one medical center hospital found substantial cross-subsidization, with healthier patients admitted for monitoring using significantly less labor resources than sicker patients. Both groups had equal bed charges. This suggests that the resource costs of admitting stable patients to an ICU for monitoring are smaller than their average bed charge. On the other hand, the actual resource costs of treating sicker patients are almost twice their billed ICU charges. ICU care is approximately 3.8 times more expensive than routine hospital care, a higher ratio than previously estimated. These results should be considered when estimating the national cost of treating severely ill patients and when proposing changes in hospital reimbursement policies, especially with regard to ICU patients.