Parameters:
(1) type of patient (surgical vs medical)
(2) number of hospital days not in ICU
(3) number of days in ICU
(4) number of admissions to ICU during an admission
(5) transfer from another hospital
The weighting depends on the ratio of cost between ICU and ward days, with ICU costs typically 3 to 4 times cost of a regular hospital bed.
|
Type of Hospital Day
|
Weighted Days
|
|
non-ICU hospital days
|
1 * (days)
|
|
admission day to ICU, surgical patient
|
4
|
|
admission day to ICU, medical patient
|
3
|
|
second day in ICU, surgical patient
|
see below
|
|
second day in ICU, medical patient
|
2
|
|
subsequent days in ICU
|
2 * (days)
|
|
readmission to ICU
|
see below
|
|
days at another hospital if transferred in
|
0
|
Second day in ICU for surgical patient: Rapoport et al scored 3, Higgins et al 2.5.
Readmission to the ICU: Rapoport et al scored an admission day (4 or 3) for each previous admission but apparently did not score additional days differently if the length of ICU stay was not known. Higgins et al added 2 per day (considered an additional ICU day). I would be tended to treat every ICU admission separately.
For the implementation, I used (a) Rapoport et al's scores for second ICU day and (b) Higgin's et al handling of multiple ICU admissions.
