• Luisa Franzini, Kavita R Sail, Eric J Thomas, and Laura Wueste.
• The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX 77030, USA. luisa.franzini@uth.tmc.edu
• J Crit Care. 2011 Jun 1;26(3):329.e1-6.

PurposeThe purpose of this study is to estimate the costs and cost-effectiveness of a telemedicine intensive care unit (ICU) (tele-ICU) program.Materials And MethodsWe used an observational study with ICU patients cared for during the pre-tele-ICU period and ICU patients cared for during the post-tele-ICU period in 6 ICUs at 5 hospitals that are part of a large nonprofit health care system in the Gulf Coast region. We obtained data on a sample of 4142 ICU patients: 2034 in the pre-tele-ICU period and 2108 in the post-tele-ICU period. Economic outcomes were hospital costs, ICU costs and floor costs, measured for average daily costs, costs per case, and costs per patient.ResultsAfter the implementation of the tele-ICU, the hospital daily cost increased from $4302 to $5340 (24%); the hospital cost per case, from $21,967 to $31,318 (43%); and the cost per patient, from $20,231 to $25,846 (28%). Although the tele-ICU intervention was not cost-effective in patients with Simplified Acute Physiology Score II 50 or less, it was cost-effective in the sickest patients with Simplified Acute Physiology Score II more than 50 (17% of patients) because it decreased hospital mortality without increasing costs significantly.ConclusionsHospital administrators may conclude that a tele-ICU program aimed at the sickest patients is cost-effective.Copyright © 2011 Elsevier Inc. All rights reserved.

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