Setting up an ICU at home: what it involves

When home ICU makes sense

Home ICU suits patients who are stable but dependent — on a ventilator long-term, in a prolonged coma, or in advanced illness where hospital admission adds infection risk without adding benefit. It is not appropriate for unstable patients who may need immediate surgical intervention.

The decision should always be made with the treating intensivist, not independently by the family.

What gets installed

A typical home ICU setup includes a hospital bed with side rails, a multipara monitor for heart rate, oxygen saturation and blood pressure, an oxygen concentrator or cylinder supply, suction apparatus, and a ventilator where prescribed. An alternating-pressure mattress is standard for immobile patients.

The room needs a stable power supply with backup, space to move around the bed on both sides, and reasonable ventilation.

Staffing is the real cost

Equipment is usually rented and is the smaller part of the budget. The recurring cost is nursing — critical-care trained nurses working in rotation to cover all 24 hours, which is what makes the arrangement safe.

Even so, home ICU typically works out considerably less expensive than an equivalent hospital ICU stay over months, which is why families with long-term patients choose it.

Have an escalation plan

Agree in advance with the treating doctor on which readings or symptoms mean the patient goes back to hospital, and keep an ambulance service number by the bed. A home ICU without a clear escalation plan is where the arrangement becomes risky.