Background: The demand for ECMO support has grown. Its provision remains limited due to several factors (high cost, complicated technology, lack of expertise) which increase healthcare cost. Our goal was to assess if an ICU run ECMO model (without continuous bedside perfusion) would decrease costs while maintaining patient safety and outcomes.
Method: We performed a retrospective review that analyzed the cost and safety benefits of a newly implemented ICU-run ECMO unit from 2011-2012. The program consisted of a dedicated ICU involving multidisciplinary providers (ICU RN, mid-level providers and intensivists). In year one, we introduced an education platform, new technology and dedicated space. In year two, the multidisciplinary providers (MDPs) adopted continuous bedside perfusion support. New management algorithms designating MDPs as first responders were established. The primary end point included total cost, while the secondary end points were the RN ratios and patients’ safety. We compared these parameters with the previous model.
Results: During the study period, 75 patients were placed on ECMO (mean days: 10). The total hospital expenditure for the previous ECMO model was $623,070 compared to $302,328 respectively, showing a 46.8% decrease in cost. This cost decrease was attributed to a decreased utilization of perfusionist services and the introduction of longer lasting and more efficient ECMO technology. We did not find any significant changes in RN ratios or any differences in outcomes related to ICU safety events.
Conclusion: We demonstrated that the ICU run ECMO model managed to lower hospital cost by reducing the cost of continuous bedside perfusion support with no loss in safety or outcomes.
Recommended CitationHong, En Yaw; Wallace, Suzanne; Tropea, Amy; Byrne, MSN, RN, Jaime; Hirose, MD, PhD, Hitoshi; Pitcher, MD, Harrsion; and Cavarocchi, MD, Nicholas C., "A cost reducing ECMO model: a single institutional experience." (2013). Department of Surgery Faculty Papers. Paper 103.