OBJECTIVE: To evaluate patient outcome and the efficiency of stays in intensive care units (ICUs). DESIGN: Prospective study. SETTING: Seven ICUs of teaching hospitals in the Paris area. PATIENTS: Two hundred eleven stays including one in three consecutive patients admitted from September to November 1996. MEASUREMENTS AND MAIN RESULTS: For each patient, the following information was collected during the ICU stay: diagnosis, severity scores, organ failures, workload, cost and mortality. A cost-effectiveness ratio was computed for 176 stays with at least one organ failure, at hospital discharge and 6 months later. Quality of life was measured with EuroQol questionnaires 6 months after discharge in 64 patients representing 62 % of the patients contacted. The mean total ICU cost per stay was US$ 14,130 (+/- 6,550) (higher for non-survivors--US$ 19,060, median 10,590--than for survivors US$ 12,370, median 5,780). The incremental cost-effectiveness ratio was US$ 1,150 per life-year saved and the incremental cost-utility ratio was US$ 4,100 per quality-adjusted life-year (QALY) saved, without discounting. These results compare favourably with other health-care options. However substantial variations were observed according to age, severity, diagnosis, number of organ failures and discount rate. Intoxication had the lowest ratio (US$ 620/QALY) and acute renal insufficiency the highest (US$ 30,625/QALY). CONCLUSIONS: This work provides medical and economic information on ICU stays in teaching hospitals and enables comparisons with other health-care options.
OBJECTIVE: To evaluate patient outcome and the efficiency of stays in intensive care units (ICUs). DESIGN: Prospective study. SETTING: Seven ICUs of teaching hospitals in the Paris area. PATIENTS: Two hundred eleven stays including one in three consecutive patients admitted from September to November 1996. MEASUREMENTS AND MAIN RESULTS: For each patient, the following information was collected during the ICU stay: diagnosis, severity scores, organ failures, workload, cost and mortality. A cost-effectiveness ratio was computed for 176 stays with at least one organ failure, at hospital discharge and 6 months later. Quality of life was measured with EuroQol questionnaires 6 months after discharge in 64 patients representing 62 % of the patients contacted. The mean total ICU cost per stay was US$ 14,130 (+/- 6,550) (higher for non-survivors--US$ 19,060, median 10,590--than for survivors US$ 12,370, median 5,780). The incremental cost-effectiveness ratio was US$ 1,150 per life-year saved and the incremental cost-utility ratio was US$ 4,100 per quality-adjusted life-year (QALY) saved, without discounting. These results compare favourably with other health-care options. However substantial variations were observed according to age, severity, diagnosis, number of organ failures and discount rate. Intoxication had the lowest ratio (US$ 620/QALY) and acute renal insufficiency the highest (US$ 30,625/QALY). CONCLUSIONS: This work provides medical and economic information on ICU stays in teaching hospitals and enables comparisons with other health-care options.
Authors: David W Dowdy; Mark P Eid; Artyom Sedrakyan; Pedro A Mendez-Tellez; Peter J Pronovost; Margaret S Herridge; Dale M Needham Journal: Intensive Care Med Date: 2005-04-01 Impact factor: 17.440
Authors: Annika Ahlström; Minna Tallgren; Seija Peltonen; Pirjo Räsänen; Ville Pettilä Journal: Intensive Care Med Date: 2005-07-28 Impact factor: 17.440
Authors: Brent C Opmeer; Kimberly R Boer; Oddeke van Ruler; Johannes B Reitsma; Hein G Gooszen; Peter W de Graaf; Bas Lamme; Michael F Gerhards; E Philip Steller; Cecilia M Mahler; Huug Obertop; Dirk J Gouma; Patrick Mm Bossuyt; Corianne Ajm de Borgie; Marja A Boermeester Journal: Crit Care Date: 2010-05-27 Impact factor: 9.097