Determining the economic cost of ICU treatment: a prospective "micro-costing" study.
Affiliation
Department of Intensive Care, Adelaide and Meath Hospital, The National, Children's Hospital, Tallaght, Dublin 24, Ireland. annemmclaughlin@gmail.comIssue Date
2012-02-01T10:50:23ZMeSH
AgedCosts and Cost Analysis
Critical Illness
Female
Great Britain
Humans
Intensive Care Units/*economics
Male
Middle Aged
Prospective Studies
Metadata
Show full item recordCitation
Intensive Care Med. 2009 Dec;35(12):2135-40. Epub 2009 Sep 15.Journal
Intensive care medicineDOI
10.1007/s00134-009-1622-1PubMed ID
19756509Abstract
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 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
engISSN
1432-1238 (Electronic)0342-4642 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1007/s00134-009-1622-1
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