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Variable costs of ICU patients: a multicenter prospective study

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Abstract

Objective

To analyze the costs of treating critically ill patients.

Design and setting

Multicenter, observational, prospective, cohort, bottom-up study on variable costs in 51 ICUs.

Patients and participants

A total of 1,034 patients aged over 14 years who either spent less than 48 h in the ICU or had multiple trauma, major abdominal surgery, ischemic stroke, chronic obstructive pulmonary disease, cardiac failure, isolated head injury, acute lung injury/adult respiratory distress syndrome (ALI/ARDS), nontraumatic intracranial hemorrhage or coronary surgery.

Interventions

Data recorded for each patient: length of ICU stay, and cost in euros of all diagnostic and therapeutic procedures, drugs and equipment used, and consultations by physicians from other units. To express cost-efficiency we calculated for each diagnostic group the cost per surviving patient (expenditure for all patients/number of surviving patients) and money loss per patient (expenditure for patients who died/total number of patients).

Measurements and results

Median costs for a multiple trauma patient were €4076 and for coronary surgery patient €380. The variability is largely due to different lengths of ICU stay. Cost per surviving patient was higher for ALI/ARDS, nontraumatic intracranial hemorrhage, multiple trauma, and emergency abdominal surgery. Money loss per patient was higher for ALI/ARDS and lower for multiple trauma. Planned coronary and major abdominal surgery and short-stay patients were treated most cost-efficiently.

Conclusions

Cost of treatment in an ICU varies widely for different types of patients. Strategies are needed to contain the major determinants of high costs and low cost-efficiency.

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Acknowledgements

The complete list of participants in the Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva is as follows: Barberis Bruno, Rivoli; Biancofiore Gianni, Pisa; Carnevale Livio, Pavia; Cesaro Paolo, Giugliano in Campania; Ciceri Gabriella, Desio; Ciceri Rita, Lecco; Cirillo Francesco Maria, Legnago; Del Sarto Paolo, Massa; Digito Antonio, Vicenza; Doldo Giuseppe, Reggio Calabria; Franco Gabriele, Castellana Grotte; Fulgenzi Giuliano, Pesaro; Garelli Alberto, Ravenna; Giannoni Stefano, Empoli; Gorietti Adonella, Perugia; Guadagnucci Alberto, Massa; Lagomarsini Ginetta, Pisa; Lavacchi Luca, Pistoia; Maitan Stefano, Faenza; Malacarne Paolo, Pisa; Mancinelli Annetta, Chieti; Mantovani Giorgio, Ferrara; Marafon Silvio, Vicenza; Marcora Barbara, Monza; Melis Piergiorgio, Lucca; Muttini Stefano, Vimercate; Negri Giovanni, Pavia; Neri Massimo, Bologna; Paternesi Nazareno, Macerata; Pecunia Laura, Genova; Pennacchioni Silvio, Ancona; Pergolo Augusto, Genua; Pessina Carla, Rho; Postiglione Maurizio, Naples; Quattrocchi Pasqualino, Catania; Radrizzani Danilo, Legnago; Rossi Giancarlo, Livorno; Rotelli Stefano, Milano; Salvi Giovanni, Imperia; Segala Vincenzo, Torino; Siviero Silvano, Rovigo; Solinas Giommaria, Lanusei; Spadini Elisabetta, Parma; Tavola Mario, Lecco; Terragni Pierpaolo, Torino; Todesco Livio, Cittadella; Trivella Patrizia, Bergamo; Visconti Maria Grazia, Cernusco sul Naviglio; Zanforlin Giancarlo, Milano; Zappa Sergio, Brescia. We are indebted to J.D. Baggott for revision of the manuscript.

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Correspondence to Guido Bertolini.

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For the Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva. GiViTI is the recipient of educational grants from: AstraZeneca Italy, Sanofi-Aventis Italy, and Draeger Italia. A complete list of study participants is presented under Acknowledgements.

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Rossi, C., Simini, B., Brazzi, L. et al. Variable costs of ICU patients: a multicenter prospective study. Intensive Care Med 32, 545–552 (2006). https://doi.org/10.1007/s00134-006-0080-2

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  • DOI: https://doi.org/10.1007/s00134-006-0080-2

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