Background. Intensive care services are one of the largest cost drivers in a hospital. Increasing life expectancy and comorbidities have resulted in an increased need for intensive care beds.

Objectives. To conduct a cost analysis of intensive care services at a central hospital in the public sector in South Africa (SA).

Methods. A retrospective cost analysis for the 2015/16 financial year was conducted across two intensive care units (ICUs), a trauma ICU (10 beds) and a combined ICU for neurosurgery, medicine and surgery (18 beds). A mixed-methods costing approach was used based on the availability of data. The bottom-up approach was used to calculate the cost of clinical support, pharmaceuticals, consumables and human resources. The top-down approach was used to allocate the cost of equipment and goods and services.

Results. There were 544 admissions resulting in 4 987 inpatient days during the study period. The total estimated inpatient cost across the two ICUs was ZAR114 055 104, with a cost per patient day of ZAR22 870. The combined ICU cost per patient day was 58% higher than the cost per patient day in the trauma ICU (ZAR26 954 v. ZAR17 021). The mean cost per admission was ZAR157 883 in the trauma ICU and ZAR245 087 in the combined ICU. Human resources costs were the highest ICU cost driver (55%), followed by direct patient activity costs (medical consumables, pharmaceuticals, laboratory tests, radiology and blood products), which contributed 24%.