, Volume 32, Issue 4, pp 545-552
Date: 25 Feb 2006

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.

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.