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What is a critical care patient?

A critical care patient is a patient that requires intense and specialized nursing care, aggressive monitoring, and the support of multiple organs to sustain their life. 

  • Specialized nursing care: Critical care patients often require their own nurse or share a nurse with only one other patient. They often need medications or treatments two to four times an hour and need to be monitored at all times. These nurses are often trained to use equipment that nurses who treat less sick patients never use. 
  • Aggressive monitoring: Critical care patients often have special monitors that allow doctors and nurses to monitor blood pressure, the pressure within the heart itself, and pressure within the brain every second. This allows for near-instant detection of problems and rapid adjustment of medications.
  • The support of multiple organs: A critical care patient may be on a ventilator, a machine that assists the lungs. They may also be on dialysis, a machine that assists the kidneys, and a variety of devices that help the heart to pump blood through the body. 

The definition of a “critical care patient” seems complex because it is poorly defined and changes from hospital to hospital. Each hospital has different rules for what type of patient must be in an ICU and what kinds of conditions must be treated in the ICU.

* Savings estimate based on a study of more than 1 billion claims comparing self-pay (or cash pay) prices of a frequency-weighted market basket of procedures to insurer-negotiated rates for the same. Claims were collected between July 2017 and July 2019. R.Lawrence Van Horn, Arthur Laffer, Robert L.Metcalf. 2019. The Transformative Potential for Price Transparency in Healthcare: Benefits for Consumers and Providers. Health Management Policy and Innovation, Volume 4, Issue 3.

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Your actual costs may be higher or lower than these cost estimates. Check with your provider and health plan details to confirm the costs that you may be charged for a service or procedure. You are responsible for costs that are not covered and for getting any pre-authorizations or referrals required by your health plan. Neither payments nor benefits are guaranteed.

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