Estimating the Financial Impact of Surveillance Monitoring in the General Care Setting

Introduction: Surveillance monitoring using continuous pulse oximetry in the general care unit setting has been shown to reduce the need for rescue and/or transfers to higher levels of care. The costs of such an early detection system are often cited as a critical barrier to implementation. This study assesses the financial impact of such a system that has been in use at a tertiary medical center for over a decade. Methods: Patient-level cost, revenue, and operating margin data were extracted for all nonpalliative care adult patients admitted to a general care unit. Patients were segmented into subgroups by the need for rescue and/or transfer during their visit. Operating margin differences between study subgroups were quantified and used to estimate the impact of this monitoring when reductions in transfers and rescues are achieved. Results: Over the 3.5-year study interval, 31,993 patients were admitted to general care. Patients with no rescue and/or transfer generated a net positive operating margin (median: $2,016; IQR: −$4236 to $7775). Patients requiring rescue and/or transfer produced median operating margin losses of −$3516 and −$8746, respectively ( P < 0.001). Conclusion: Surveillance monitoring is operationally cost-effective, generating significant operating margin impact when associated with reductions in patients requiring rescue and/or transfer. At the study site, 10% reductions in transfers were estimated to be favorable to operating margin by over $400,000 per annum. These data support the contention that continuous monitoring and rapid response are cost-effective and affordable on an annual operational basis.