Investing in ICU rehab helps hospitals' bottom line

Johns Hopkins: ICU early rehabilitation program saves $818,000
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When hospital administrators hear proposals for adding an ICU physical therapy program, they usually ask, "How much will it cost?" But new research suggests they should be asking, "How much will it save?"

Despite concerns about costs, early physical therapy for intensive care patients cannot only improve outcomes but also the hospital's bottom line, according to a Critical Care Medicine study, published online ahead of the March print issue.

In an evaluation of the Johns Hopkins Hospital's medical intensive care unit (MICU), researchers found that early physical and occupational therapy, even for patients on life support, led to better outcomes.

The length of stay dropped from 6.5 days to five days at an average of 23 percent, according to a research announcement Friday. One reason is that ICU care often means long periods of bed rest for critically ill patients. By preventing muscle weakness, patients are better equipped to care for themselves after discharge.

The up-front costs are defrayed by the financial savings. The rehabilitation program, with dedicated physical and occupational therapists, added about $358,000 to care costs each year, but the net cost savings for the hospital amounted to about $818,000 annually, researchers found.

Johns Hopkins noted that the low up-front investment can yield a high return for most hospitals in the United States.

When researchers looked at other hospitals with various ICU admissions and length of stay, they estimated hospitals would range from losing $87,611 in net costs to reaping $3,763,149 in net savings.

"We found that in 20 out of the 24 scenarios, hospitals would have an overall cost savings by providing early rehabilitation to their intensive care unit patients, and in the four remaining scenarios, using the most conservative assumptions, there was a modest net cost increase of up to $88,000 per year," lead study author Robert Lord said.

For more information:
- see the announcement
- here's the study abstract

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