Ilse van Beusekom1, Ferishta Bakhshi-Raiez2, Nicolette F de Keizer2, Marike van der Schaaf3, Wim B Busschers2, Dave A Dongelmans4. 1. Academic Medical Center, University of Amsterdam, Department: Medical Informatics, Amsterdam Public Health research institute, Amsterdam, The Netherlands; National Intensive Care Evaluation (NICE) foundation, Amsterdam, The Netherlands. Electronic address: i.vanbeusekom@amc.uva.nl. 2. Academic Medical Center, University of Amsterdam, Department: Medical Informatics, Amsterdam Public Health research institute, Amsterdam, The Netherlands; National Intensive Care Evaluation (NICE) foundation, Amsterdam, The Netherlands. 3. Academic Medical Center, University of Amsterdam, Department: Rehabilitation, Amsterdam, The Netherlands; ACHIEVE, Center of Expertise, University of Applied Sciences, Amsterdam School of Health Professions, Amsterdam, The Netherlands. 4. National Intensive Care Evaluation (NICE) foundation, Amsterdam, The Netherlands; Academic Medical Center, University of Amsterdam, Department: Intensive Care Medicine, Amsterdam, The Netherlands.
Abstract
PURPOSE: To identify subgroups of ICU patients with high healthcare utilization for healthcare expenditure management purposes such as prevention and targeted care. MATERIALS AND METHODS: We conducted a descriptive cohort study, combining a national health insurance claims database and a national quality registry database for ICUs. Claims data in the timeframe 2012-2014 were combined with the clinical data of ICU patients admitted to an ICU during 2013. A population based control group was created based on the ICU population. RESULTS: 56,760 ICU patients and 75,232 controls from the general population were included. Median healthcare costs per day alive for the ICU population were significantly higher during the year before (€8.9 (IQR €2.4; €32.1)) and the year after ICU admission (€15.4 (IQR €5.4; €51.2)) compared to the control group ((€2.8 (IQR €0.7; €8.8) and €3.1 (IQR €0.8; €10.1)). ICU patients with more chronic conditions had significantly higher healthcare costs before and after ICU admission compared to ICU patients with less chronic conditions. CONCLUSIONS: ICU patients have three to five times higher healthcare costs per day alive compared to a control population. Our findings can be used to optimize the healthcare trajectories of ICU patients with high healthcare utilization after discharge.
PURPOSE: To identify subgroups of ICU patients with high healthcare utilization for healthcare expenditure management purposes such as prevention and targeted care. MATERIALS AND METHODS: We conducted a descriptive cohort study, combining a national health insurance claims database and a national quality registry database for ICUs. Claims data in the timeframe 2012-2014 were combined with the clinical data of ICU patients admitted to an ICU during 2013. A population based control group was created based on the ICU population. RESULTS: 56,760 ICU patients and 75,232 controls from the general population were included. Median healthcare costs per day alive for the ICU population were significantly higher during the year before (€8.9 (IQR €2.4; €32.1)) and the year after ICU admission (€15.4 (IQR €5.4; €51.2)) compared to the control group ((€2.8 (IQR €0.7; €8.8) and €3.1 (IQR €0.8; €10.1)). ICU patients with more chronic conditions had significantly higher healthcare costs before and after ICU admission compared to ICU patients with less chronic conditions. CONCLUSIONS: ICU patients have three to five times higher healthcare costs per day alive compared to a control population. Our findings can be used to optimize the healthcare trajectories of ICU patients with high healthcare utilization after discharge.
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