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February 1983

The Intermediate Coronary Care Unit-Reply

Author Affiliations

Dayton, Ohio

Arch Intern Med. 1983;143(2):388. doi:10.1001/archinte.1983.00350020218047

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In Reply.  —The comments by Frieden and Cooper show that they have missed the point of the article. The cost comparison should, indeed, be with ordinary rooms and not with the CCU. The thesis of the article is that there are too many intermediate care beds being used for patients who do not need monitoring and who should be in ordinary hospital beds—not in the CCU. I am not arguing that postmyocardial infarction patients should be denied step-down or intermediate monitoring. If intermediate unit monitoring was limited to postmyocardial infarction patients, the vast proliferation of monitored beds throughout the United States would not have occurred.The arithmetic that I quoted is correct. Most institutions charge a $2 to $3/hr monitoring fee plus an additional nursing charge of $5/hr. This means a minimum of $7/hr. This multiplied by 24 equals $168, which, multiplied by ten would be $1,680 additional fees over

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