Özet:

Aim: As the ageing population of Turkey increases, so there is an increase in chronic diseases, resulting in an increase in both the need for intensive care (IC) and healthcare expenditure. The aim of this study was to contribute to the preparation of sustainable healthcare policies for long-term IC patients and to the planning of healthcare services.  Method: A retrospective examination was made of the records of patients in a level 3 IC unit (ICU) in a level 2 hospital. For each of the 717 patients included in the study, a record was made of the age, gender, clinical status, length of stay in ICU, prognosis and the hospital bill according to the principles of the Healthcare Application Declaration. Then a theoretical calculation was made for each patient of the same services under the same conditions in a level 3 ICU in a level 3 hospital.  Results: The mean age of patients was 76.0 years and mean length of stay in the level 3 ICU of the level 2 hospital was 28.0 days. The mortality rate in ICU of these patients was 84.4%. The costs of the healthcare services which could be billed to the National Social Services were 1,156.90 TL – 569,590.66 TL. If the same patients had been admitted and treated in a level 3 ICU of a level 3 hospital, the charges which could be billed to Social Services were calculated as 1,250.02 TL – 624,333.35 TL. The treatment of patients in a level 3 ICU in level 2 hospitals showed a mean lower cost of 1,932.29 TL per patient and a total saving of 2,721,225.27 for the total 717 patients.  Conclusion:  The transfer of patients in a level 3 hospital to a level 3 ICU in a level 2 hospital allows those beds to be used for those in need of acute care and differentiates patients who could have a good prognosis, and the resources allocated for these services can be used in a more effective and productive way. Therefore, the concept of long-term, intensive care hospitals should be discussed and implemented. 

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