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Intensive Care Med. 2001 Jan;27(1):146-53.

A cost-effectiveness analysis of stays in intensive care units.

Author information

1
Department of Public Health and Medical Informatics, Hospital Ambroise Paré, Boulogne, France.

Abstract

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.

PMID:
11280626
[Indexed for MEDLINE]

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