Determining the economic cost of ICU treatment: a prospective "micro-costing" study.

Hdl Handle:
http://hdl.handle.net/10147/207929
Title:
Determining the economic cost of ICU treatment: a prospective "micro-costing" study.
Authors:
McLaughlin, Anne Marie; Hardt, Judy; Canavan, James B; Donnelly, Maria B
Affiliation:
Department of Intensive Care, Adelaide and Meath Hospital, The National, Children's Hospital, Tallaght, Dublin 24, Ireland. annemmclaughlin@gmail.com
Citation:
Intensive Care Med. 2009 Dec;35(12):2135-40. Epub 2009 Sep 15.
Journal:
Intensive care medicine
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207929
DOI:
10.1007/s00134-009-1622-1
PubMed ID:
19756509
Abstract:
OBJECTIVE: To prospectively assess the cost of patients in an adult intensive care unit (ICU) using bottom-up costing methodology and evaluate the usefulness of "severity of illness" scores in estimating ICU cost. METHODS AND DESIGN: A prospective study costing 64 consecutive admissions over a 2-month period in a mixed medical/surgical ICU. RESULTS: The median daily ICU cost (interquartile range, IQR) was 2,205 euro (1,932 euro-3,073 euro), and the median total ICU cost (IQR) was 10,916 euro (4,294 euro-24,091 euro). ICU survivors had a lower median daily ICU cost at <euro>2,164 per day, compared with 3,496 euro per day for ICU non-survivors (P = 0.08). The requirements for continuous haemodiafiltration, blood products and anti-fungal agents were associated with higher daily and overall ICU costs (P = 0.002). Each point increase in SAPS3 was associated with a 305 euro (95% CI 31 euro-579 euro) increase in total ICU cost (P = 0.029). However, SAPS3 accounted for a small proportion of the variance in this model (R (2) = 0.08), limiting its usefulness as a stand-alone predictor of cost in clinical practice. A model including haemodiafiltration, blood products and anti-fungal agents explained 54% of the variance in total ICU cost. CONCLUSION: This bottom-up costing study highlighted the considerable individual variation in costs between ICU patients and identified the major factors contributing to cost. As the requirement for expensive interventions was the main driver for ICU cost, "severity of illness" scores may not be useful as stand-alone predictors of cost in the ICU.
Language:
eng
MeSH:
Aged; Costs and Cost Analysis; Critical Illness; Female; Great Britain; Humans; Intensive Care Units/*economics; Male; Middle Aged; Prospective Studies
ISSN:
1432-1238 (Electronic); 0342-4642 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorMcLaughlin, Anne Marieen_GB
dc.contributor.authorHardt, Judyen_GB
dc.contributor.authorCanavan, James Ben_GB
dc.contributor.authorDonnelly, Maria Ben_GB
dc.date.accessioned2012-02-01T10:50:23Z-
dc.date.available2012-02-01T10:50:23Z-
dc.date.issued2012-02-01T10:50:23Z-
dc.identifier.citationIntensive Care Med. 2009 Dec;35(12):2135-40. Epub 2009 Sep 15.en_GB
dc.identifier.issn1432-1238 (Electronic)en_GB
dc.identifier.issn0342-4642 (Linking)en_GB
dc.identifier.pmid19756509en_GB
dc.identifier.doi10.1007/s00134-009-1622-1en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207929-
dc.description.abstractOBJECTIVE: To prospectively assess the cost of patients in an adult intensive care unit (ICU) using bottom-up costing methodology and evaluate the usefulness of "severity of illness" scores in estimating ICU cost. METHODS AND DESIGN: A prospective study costing 64 consecutive admissions over a 2-month period in a mixed medical/surgical ICU. RESULTS: The median daily ICU cost (interquartile range, IQR) was 2,205 euro (1,932 euro-3,073 euro), and the median total ICU cost (IQR) was 10,916 euro (4,294 euro-24,091 euro). ICU survivors had a lower median daily ICU cost at <euro>2,164 per day, compared with 3,496 euro per day for ICU non-survivors (P = 0.08). The requirements for continuous haemodiafiltration, blood products and anti-fungal agents were associated with higher daily and overall ICU costs (P = 0.002). Each point increase in SAPS3 was associated with a 305 euro (95% CI 31 euro-579 euro) increase in total ICU cost (P = 0.029). However, SAPS3 accounted for a small proportion of the variance in this model (R (2) = 0.08), limiting its usefulness as a stand-alone predictor of cost in clinical practice. A model including haemodiafiltration, blood products and anti-fungal agents explained 54% of the variance in total ICU cost. CONCLUSION: This bottom-up costing study highlighted the considerable individual variation in costs between ICU patients and identified the major factors contributing to cost. As the requirement for expensive interventions was the main driver for ICU cost, "severity of illness" scores may not be useful as stand-alone predictors of cost in the ICU.en_GB
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshCosts and Cost Analysisen_GB
dc.subject.meshCritical Illnessen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshGreat Britainen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIntensive Care Units/*economicsen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshProspective Studiesen_GB
dc.titleDetermining the economic cost of ICU treatment: a prospective "micro-costing" study.en_GB
dc.contributor.departmentDepartment of Intensive Care, Adelaide and Meath Hospital, The National, Children's Hospital, Tallaght, Dublin 24, Ireland. annemmclaughlin@gmail.comen_GB
dc.identifier.journalIntensive care medicineen_GB
dc.description.provinceLeinster-

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