Use of care levels in the postanesthesia care setting.

Most hospitals no longer charge a flat postanesthesia care rate, although many have only one charge code based on unit of time to cover all patients regardless of the level or intensity of their care. The author reports a mechanism developed to charge patients for PACU care based on both length of time and level or intensity of care required. Objectives of the project included a more accurate determination of cost of care provided to each patient, and provision of accurate data for productivity measurement and reporting on an ongoing basis. The installed system, based on four levels of care, provided the following results: more accurate cost of PACU care data reflecting both length and intensity of care; more accurate PACU workload units provided to hospital-wide productivity reporting system; patients charged based on both level and intensity of nursing care in the PACU; nurses feeling that their care efforts are recognized and appreciated; and estimation of overall workload for the next day along with when workload should peak.