Literature DB >> 12647086

[Cost analysis and outcome prediction with the Therapeutic Intervention Scoring System (TISS and TISS-28].

Jürgen Graf1, Carmen Graf, Karl-Christian Koch, Peter Hanrath, Uwe Janssens.   

Abstract

BACKGROUND AND
PURPOSE: The "Therapeutic Intervention Scoring System" (TISS) and the simplified version TISS-28 obtain the therapeutic workload in the critically ill and may be used for outcome prediction. The feasibility and applicability regarding cost analysis and outcome prediction of TISS and TISS-28 have been assessed in 303 consecutive medical patients staying longer than 24 h in the intensive care unit (ICU). PATIENTS AND METHODS: The mean age of the enrolled patients was 62 +/- 12 years, 216 (71%) patients were male, length of ICU stay 3.7 +/- 4.7 days, and SAPS II (Simplified Acute Physiology Score) 26 +/- 13 points. The overall mortality was 44 patients (14.5%) with 25 patients (8.3%) dying while on the ICU.
RESULTS: The data collection process for TISS took significantly longer than for TISS-28. On the day of admission, the correlation of TISS and TISS-28 was excellent (r(2) = 0.91; p < 0.001). The discriminatory power as assessed by the area under the receiver operating characteristic (ROC) curve was satisfactory for TISS (0.79 +/- 0.04), TISS-28 (0.76 +/- 0.04), and SAPS II (0.77 +/- 0.04) with regard to outcome prediction. Patient-specific costs per TISS-28 point amounted to 36 euros.--and were significantly higher than the 25 euros.--calculated per TISS point. Staff costs (42%) were the most prominent cost-generating factor, and patient-specific costs contributed two thirds to the total ICU costs. There was no association of severity of illness or number of organ failure and costs. Only the length of ICU stay correlated strongly with the costs of the individual patients during the ICU stay (r(2) = 0.79; p < 0.001).
CONCLUSION: The faster data collection process as well as the uniformity of the system are strong clinical and scientific advantages of the TISS-28. In addition, TISS-28 is capable of calculating individual costs in an acceptable time frame. Therefore TISS-28 serves as a valuable tool for quality assurance and cost analysis purposes in the medical ICU.

Entities:  

Mesh:

Year:  2003        PMID: 12647086     DOI: 10.1007/s00063-003-1235-3

Source DB:  PubMed          Journal:  Med Klin (Munich)        ISSN: 0723-5003


  8 in total

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Authors:  O Ackermann; A Wetter; E Chelangattucherry; I Emmanouilidis; C Rülander
Journal:  Unfallchirurg       Date:  2011-01       Impact factor: 1.000

2.  Ultrasound diagnosis of juvenile forearm fractures.

Authors:  Ole Ackermann; Peter Liedgens; Kolja Eckert; Emmanuel Chelangattucherry; Christian Ruelander; Ioannis Emmanouilidis; Steffen Ruchholtz
Journal:  J Med Ultrason (2001)       Date:  2010-04-23       Impact factor: 1.314

3.  [Cost analysis as a tool for assessing the efficacy of intensive care units].

Authors:  T Maierhofer; F Pfisterer; A Bender; H Küchenhoff; O Moerer; H Burchardi; W H Hartl
Journal:  Med Klin Intensivmed Notfmed       Date:  2017-06-16       Impact factor: 0.840

Review 4.  [Introduction of the flat rate reimbursement system in Germany : A historical review].

Authors:  H Burchardi
Journal:  Med Klin Intensivmed Notfmed       Date:  2017-10-24       Impact factor: 0.840

Review 5.  Economic aspects of severe sepsis: a review of intensive care unit costs, cost of illness and cost effectiveness of therapy.

Authors:  Hilmar Burchardi; Heinz Schneider
Journal:  Pharmacoeconomics       Date:  2004       Impact factor: 4.981

6.  [Ultrasound diagnosis of forearm fractures in children: a prospective multicenter study].

Authors:  O Ackermann; P Liedgens; K Eckert; E Chelangattucherry; B Husain; S Ruchholtz
Journal:  Unfallchirurg       Date:  2009-08       Impact factor: 1.000

7.  Direct, indirect, and intangible costs after severe trauma up to occupational reintegration - an empirical analysis of 113 seriously injured patients.

Authors:  Benjamin Anders; Oliver Ommen; Holger Pfaff; Markus Lüngen; Rolf Lefering; Sonja Thüm; Christian Janssen
Journal:  Psychosoc Med       Date:  2013-06-17

8.  A surge of flu-associated adult respiratory distress syndrome in an Austrian tertiary care hospital during the 2009/2010 Influenza A H1N1v pandemic.

Authors:  Peter Schellongowski; Roman Ullrich; Cornelia Hieber; Hubert Hetz; Heidrun Losert; Maria Hermann; Alexander Hermann; Klaus-Bernhard Gattringer; Viktoria Siersch; Werner Rabitsch; Valentin Fuhrmann; Andja Bojic; Oliver Robak; Wolfgang R Sperr; Klaus Laczika; Gottfried J Locker; Thomas Staudinger
Journal:  Wien Klin Wochenschr       Date:  2011-04-07       Impact factor: 1.704

  8 in total

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