Chronic Care Units as a Health System Cost Containment Strategy: Real-World Evidence From Colombia (2023-2024)
Author(s)
JUAN C. FERNANDEZ MERCADO, MBA, MSc, PhD, MD1, Nelson Alvis-Guzman, MPH, PhD, MD2, MANUEL CABALLERO TABOADA, MD. Esp.3.
1UNIVERSIDAD DE CARTAGENA, Cartagena, Colombia, 2Universidad de Cartagena - ALZAK Foundation, Cartagena, Colombia, 3DIRECTOR MEDICO, SEDARTE UNIDAD DE CRONICOS, MONTERIA SINCELEJO, Colombia.
1UNIVERSIDAD DE CARTAGENA, Cartagena, Colombia, 2Universidad de Cartagena - ALZAK Foundation, Cartagena, Colombia, 3DIRECTOR MEDICO, SEDARTE UNIDAD DE CRONICOS, MONTERIA SINCELEJO, Colombia.
OBJECTIVES: To assess the contribution of chronic care units (CCUs) to national health system sustainability through the reduction of high-cost, prolonged hospitalizations and inappropriate ICU usage in Colombia.
METHODS:
A retrospective analysis of 660 chronic patient admissions between 2023-2024 was conducted in two specialized CCUs with 104 beds operating at 82% average occupancy. The model included ventilated and non-ventilated chronic patients with prolonged stays (mean: 93 days). Cost per patient was compared between ICU (USD $900/day) and CCUs (USD $133/day ventilated; USD $93/day non-ventilated), with projections on system-level cost avoidance.
RESULTS:
CCUs generated monthly system-wide savings of USD $23,000 per ventilated patient, and over USD $98,000/month in total savings across 29 patients. Compared to standard care, the model reduced total hospitalization costs by over 75%, with no compromise in continuity or quality of care. The annualized savings potential exceeds USD $1.17 million for 330 patients/year, representing a scalable cost containment strategy for low- and middle-income health systems.
CONCLUSIONS:
Chronic care units are a strategic health economic intervention that can mitigate the rising costs of complex chronic patients. Their integration into insurer-provider contracting models in Colombia is essential to ensure efficiency, sustainability, and value-based healthcare delivery.
METHODS:
A retrospective analysis of 660 chronic patient admissions between 2023-2024 was conducted in two specialized CCUs with 104 beds operating at 82% average occupancy. The model included ventilated and non-ventilated chronic patients with prolonged stays (mean: 93 days). Cost per patient was compared between ICU (USD $900/day) and CCUs (USD $133/day ventilated; USD $93/day non-ventilated), with projections on system-level cost avoidance.
RESULTS:
CCUs generated monthly system-wide savings of USD $23,000 per ventilated patient, and over USD $98,000/month in total savings across 29 patients. Compared to standard care, the model reduced total hospitalization costs by over 75%, with no compromise in continuity or quality of care. The annualized savings potential exceeds USD $1.17 million for 330 patients/year, representing a scalable cost containment strategy for low- and middle-income health systems.
CONCLUSIONS:
Chronic care units are a strategic health economic intervention that can mitigate the rising costs of complex chronic patients. Their integration into insurer-provider contracting models in Colombia is essential to ensure efficiency, sustainability, and value-based healthcare delivery.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE123
Topic
Economic Evaluation, Organizational Practices, Real World Data & Information Systems
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Personalized & Precision Medicine