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A one day substitution of general ward for ICU care would result in a cost reduction of $1,200 per patient for survivors.
This translates into a cost avoidance of approximately $428,685 per 100 admissions to the ICU.
High-severity admissions gained the most, and were more cost-effective. On average, ICU admission versus general ward care was cost-effective at a threshold of €22,000/QALY (p = 95%).
Among the simulated patients who used the ICU, the receipt of both interventions could have resulted in ICU cost savings of 1.9 billion, representing a 6% reduction in total hospital costs for these patients.
The cost of an ICU admission in our setting is US$ 2818.
An overall 300,000€ ICU cost reduction was directly related to the protocol implementation. The implementation of a laboratory tests and chest radiographs prescription protocol within our ICU induced an important cost saving.
We conclude that although preliminary low-level evidence suggests that EM in the ICU is safe, feasible and may yield clinical benefits, EM is also labor-intensive and requires appropriate staffing models and equipment.
Cost per survivor was lower among patients directly admitted to the ICU ($37,986) than either those initially admitted to the wards ($187,230) or those sent home ($186,390) (P < 0.001).In comparison with direct admission to the ICU, patients with suspected infection admitted to the ICU who have previously been discharged home or admitted to the ward are associated with higher in-hospital mortality and costs.
Planned coronary and major abdominal surgery and short-stay patients were treated most cost-efficiently. Cost of treatment in an ICU varies widely for different types of patients.
The ICU treatment of critically ill medical patients in a resource poor country is cost effective and compares favorably with other medical interventions.

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