The Intermediate Coronary Care Unit

To the Editor. —The editorial by Weinberg in the OctoberArchives(1982; 142:1794-1795) on the intermediate coronary care unit (ICCU) is misleading. He compares the cost of intermediate coronary care with the cost of standard rooms, while, in fact, a major purpose of the ICCU is to relieve pressure on the coronary care units (CCUs) that are increasingly overcrowded. In other words, a legitimate comparison would be between the cost of ICCU and CCU care, and here the ICCU is clearly a money saver. Indeed, as our study 1 indicates, a major reason for establishing ICCUs was to increase the availability of CCU beds by allowing earlier transfer of patients with acute infarctions and ischemic episodes from the CCU. In addition, Weinberg's numbers are wrong. A ten-bed monitored unit requires one additional nurse per shift when compared with standard floor care, which implies an additional annual cost of approximately $60,000.