OBJECTIVES: Continuous monitoring (CM) of patient vital signs during their hospital stay has been shown to reduce mortality and ICU length of stay. Recently, a trend towards reduced risk for unplanned ICU transfer and rapid response team (RRT) activation has also been observed when using CM. Here the budget impact of introducing CM to the medical-surgical floor of a US hospital is assessed from the hospital perspective.

METHODS: The model was developed in Excel to estimate the costs of care for patients on the medical-surgical floor, comparing use of standard monitoring practice to use of CM of temperature, respiratory rate, heart rate, and movement. Effect data were taken from a meta-analysis of CM, with a relative risk (RR) of 0.86 (95% CI 0.67-1.11) for unplanned ICU transfer and RR 0.61 (95% CI 0.26–1.43) for RRT activation. The cost of CM was $10,000 per bed per year. Probabilistic sensitivity analysis (PSA) tested outcome robustness to changes in inputs. Costs are in 2022 USD ($).

RESULTS: Adopting CM for a hospital with 350 post-surgical patients per month using 50 monitored beds would reduce care costs from $10,381,076 to $6,385,504. During the PSA, cost savings with CM were identified in 93.8% of simulations. Use of CM reduced the cost of adverse events, saving $4,495,572 (cost saving in 97.8% of simulations). Improved patient outcomes with CM were indicated via fewer unplanned ICU transfers (31 fewer; reduced in 87.2% of simulations), RRT activations (310 fewer; reduced in 85.6% of simulations), general care floor days (1,458 fewer; reduced in 99.2% of simulations) and ICU days (539 fewer; reduced in 100% of simulations).

CONCLUSIONS: CM is expected to be a cost-saving solution for most hospitals and is likely to be of particular interest to hospitals faced with staff shortages or high workloads.