Division of Pulmonary, Critical Care, and Occupational Health, Iowa City Veterans Affairs Medical Center, Iowa City, IA; Department of Internal Medicine, University of Iowa Carver College of Medicine; the Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center, Iowa City, IA.
Division of Pulmonary, Critical Care, and Occupational Health, Iowa City Veterans Affairs Medical Center, Iowa City, IA.
Chest. 2013 Jan;143(1):19-29. doi: 10.1378/chest.11-3031.
Implementation of telemedicine programs in ICUs (tele-ICUs) may improve patient outcomes, but the costs of these programs are unknown. We performed a systematic literature review to summarize existing data on the costs of tele-ICUs and collected detailed data on the costs of implementing a tele-ICU in a network of Veterans Health Administration (VHA) hospitals.
We conducted a systematic review of studies published between January 1, 1990, and July 1, 2011, reporting costs of tele-ICUs. Studies were summarized, and key cost data were abstracted. We then obtained the costs of implementing a tele-ICU in a network of seven VHA hospitals and report these costs in light of the existing literature.
Our systematic review identified eight studies reporting tele-ICU costs. These studies suggested combined implementation and first year of operation costs for a tele-ICU of $50,000 to $100,000 per monitored ICU-bed. Changes in patient care costs after tele-ICU implementation ranged from a $3,000 reduction to a $5,600 increase in hospital cost per patient. VHA data suggested a cost for implementation and first year of operation of $70,000 to $87,000 per ICU-bed, depending on the depreciation methods applied.
The cost of tele-ICU implementation is substantial, and the impact of these programs on hospital costs or profits is unclear. Until additional data become available, clinicians and administrators should carefully weigh the clinical and economic aspects of tele-ICUs when considering investing in this technology.
在 ICU 中实施远程医疗计划（远程 ICU）可能会改善患者的预后，但这些计划的成本尚不清楚。我们进行了一项系统的文献综述，总结了现有的远程 ICU 成本数据，并收集了在退伍军人事务部（VA）医院网络中实施远程 ICU 的详细成本数据。
我们对 1990 年 1 月 1 日至 2011 年 7 月 1 日期间发表的报告远程 ICU 成本的研究进行了系统综述。对研究进行了总结，并提取了关键成本数据。然后，我们获得了在七个 VA 医院网络中实施远程 ICU 的成本，并根据现有文献报告这些成本。
我们的系统综述确定了八项报告远程 ICU 成本的研究。这些研究表明，每台监测 ICU 床位的远程 ICU 的实施和第一年运营成本为 50,000 至 100,000 美元。远程 ICU 实施后患者护理成本的变化范围为每例患者住院费用减少 3,000 美元至增加 5,600 美元。VA 数据表明，每 ICU 床位的实施和第一年运营成本为 70,000 至 87,000 美元，具体取决于所应用的折旧方法。
远程 ICU 实施的成本很高，这些计划对医院成本或利润的影响尚不清楚。在获得更多数据之前，临床医生和管理人员在考虑投资这项技术时，应仔细权衡远程 ICU 的临床和经济方面。
