costs. Critical care periods Record the number of critical care periods that have occurred within each hospital spell. A critical care period is a continuous period of care or assessment (i.e. a period of time) within a hospital provider spell during which a patient receives critical care in any one single unit function type of the critical care unit. A new critical care period commences with each new CCMDS record. Discrepancies can arise when counting critical care bed days for all types of critical care services activity. For reference costs, counting of adult, neonatal or paediatric critical care should follow the example in Table 11. Table 11: Critical care bed day count Critical care admission Critical care discharge Count date and time date and time with different dates of critical 5 November 7 November 3 critical care bed care admission and discharge 13:00 10.30 days with same date of critical care 5 November 5 November 1 critical care bed admission and discharge 13:00 22:00 day Given this counting convention, a critical care bed vacated and subsequently occupied by a second patient over the course of 24 hours should be counted as two critical care bed days. Costing critical care We would expect the following costs to be included in the cost per critical care bed day: Medical staff. Nursing and clinical staff. Therapies. Ward consumables. Drugs. Blood and blood products. Diagnostics undertaken whilst the patient is in critical care. Medical and surgical equipment. The of any theatre time must be reported against the core HRG and not the unbundled critical care HRG. If a patient’s TFC changes on admission to a critical care unit, a new FCE will begin, and theatre costs will not form part of the total cost for the critical care service. But even if a new FCE does not start on admission to critical care or an FCE is wholly within critical care under a critical care consultant from admission to discharge theatre costs should still be excluded from critical care, and reported against the core HRG. Where there is no theatre time, this may result in a relatively small or even zero cost against the core HRG. In these circumstances, trusts have the discretion to exclude these zero cost HRGs on the same principle that other zero cost HRG are excluded (paragraph 49). The key principle here is that critical care represents the highest level of complexity and only the daily costs of providing critical care should be recorded
costs. Critical care periods Record the number of critical care periods that have occurred within each hospital spell. A critical care period is a continuous period of care or assessment (i.e. a period of time) within a hospital provider spell during which a patient receives critical care in any one single unit function type of the critical care unit. A new critical care period commences with each new CCMDS record. Discrepancies can arise when counting critical care bed days for all types of critical care services activity. For reference costs, counting of adult, neonatal or paediatric critical care should follow the example in Table 11. Table 11: Critical care bed day count Critical care admission date and time Critical care discharge date and time Count with different dates of critical care admission and discharge 5 November 13:00 7 November 10.30 3 critical care bed days with same date of critical care admission and discharge 5 November 13:00 5 November 22:00 1 critical care bed day Given this counting convention, a critical care bed vacated and subsequently occupied by a second patient over the course of 24 hours should be counted as two critical care bed days. Costing critical care We would expect the following costs to be included in the cost per critical care bed day: Medical staff. Nursing and clinical staff. Therapies. Ward consumables. Drugs. Blood and blood products. Diagnostics undertaken whilst the patient is in critical care. Medical and surgical equipment. The of any theatre time must be reported against the core HRG and not the unbundled critical care HRG. If a patient’s TFC changes on admission to a critical care unit, a new FCE will begin, and theatre costs will not form part of the total cost for the critical care service. But even if a new FCE does not start on admission to critical care or an FCE is wholly within critical care under a critical care consultant from admission to discharge theatre costs should still be excluded from critical care, and reported against the core HRG. Where there is no theatre time, this may result in a relatively small or even zero cost against the core HRG. In these circumstances, trusts have the discretion to exclude these zero cost HRGs on the same principle that other zero cost HRG are excluded (paragraph 49). The key principle here is that critical care represents the highest level of complexity and only the daily costs of providing critical care should be recorded
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