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dc.contributor.authorMcLaughlin, Anne Marie
dc.contributor.authorHardt, Judy
dc.contributor.authorCanavan, James B
dc.contributor.authorDonnelly, Maria B
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 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.
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
html.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.


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