Effectiveness and efficiency of intensive care medicine: variable costs in different diagnosis groups

Acta Anaesthesiologica Scandinavica
G IapichinoItalian Group for the Evaluation of Interventions in Intensive Care Medicine

Abstract

To establish the effectiveness of ICU treatment and the efficiency in the use of resources in patients stratified according to 10 diagnosis and two levels-of-care. To propose strategies aimed at reducing costs and improving efficiency in each patient group. Multicentre prospective observational study. ICUs enrolled two cohorts of up to 10 consecutive patients with ICU stay >/= 48 h. Each with one of these diagnoses: trauma, brain-trauma, brain-hemorrhage, stroke, acute-on-chronic-obstructive-pulmonary disease, lung-injury/acute respiratory distress syndrome, heart failure, and scheduled/unscheduled abdominal surgery. The presence of active-life support divides high from low level-of-care treatments. Variable ICU costs were collected daily (bottom-up) for 21 days. We evaluated effectiveness (hospital survival) and efficiency (hospital-survivors variable-cost as a ratio of overall cost). Forty-two Italian general ICUs recruited 529 patients in 5 months. Mean ICU variable-costs significantly differed with diagnosis and level-of-care. Costs were positively affected by ICU length-of-stay, by duration of active-treatment. Outcome variably influenced costs. Medians of variable-costs per patient (1715 Euro) and patient-groups efficienc...Continue Reading

References

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Citations

Jun 10, 2010·Intensive Care Medicine·Gaetano IapichinoCharles L Sprung
Feb 18, 2006·Critical Care Medicine·Gaetano IapichinoAlberto Morabito
Jun 15, 2007·Critical Care Medicine·Brian H NathansonMaureen Stark
Aug 14, 2013·World Journal of Emergency Surgery : WJES·Osvaldo ChiaraStefania Cimbanassi
Jun 28, 2007·Critical Care : the Official Journal of the Critical Care Forum·Onnen MoererHilmar Burchardi
Apr 14, 2010·Critical Care : the Official Journal of the Critical Care Forum·Rita LinkoUNKNOWN FINNALI study investigators
Feb 1, 2009·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Hans-Christoph PapeMichael C Christensen
Aug 19, 2004·Acta Anaesthesiologica Scandinavica·J Wernerman, H Flaatten
Feb 1, 2006·Expert Review of Pharmacoeconomics & Outcomes Research·Krista M KingGregory H Botz

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