Skip to main content

Cost-Effectiveness of Postintensive Care Clinics

  • Chapter
  • First Online:
Post-Intensive Care Syndrome

Part of the book series: Lessons from the ICU ((LEICU))

  • 1896 Accesses

Abstract

Critical care survivors have ongoing physical and psychological problems affecting quality of life after discharge from the ICU. An increasing awareness of this problem has led to the organization of post-ICU clinics in which a team of healthcare specialists treat the survivors of critical illness. Despite failure to prove benefit from this intervention, the number of post-ICU clinics keeps growing. In times of financial pressure on healthcare systems, one should question the organization of systems that are not proven to be helpful. According to two landmark trials (RECOVER and PRaCTICaL) that studied the cost-effectiveness of post-ICU clinics, their practice should be abandoned given their lack of benefit with regard to effectiveness and cost-effectiveness.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 49.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 64.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 89.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Needham DM, Davidson J, Cohen H, et al. Improving long-term outcomes after discharge from intensive care unit. Crit Care Med. 2012;40:502–9.

    Article  PubMed  Google Scholar 

  2. Sukantarat K, Greer S, Brett S, Williamson R. Physical and psychological sequelae of critical illness. Br J Health Psychol. 2007;12:65–74.

    Article  PubMed  Google Scholar 

  3. Rawal G, Yadav S, Kumar R. Post-intensive care syndrome: an overview. J Trans Int Med. 2017;5:90. https://doi.org/10.1515/jtim-2016-0016.

    Article  Google Scholar 

  4. Lone NI, Seretny M, Wild SH, Rowan KM, Murray GD, Walsh TS. Surviving intensive care. Crit Care Med. 2013;41:1832–43.

    Article  PubMed  Google Scholar 

  5. Ruhl AP, Lord RK, Panek JA, et al. Health care resource use and costs of two-year survivors of acute lung injury. An observational cohort study. Ann Am Thorac Soc. 2015;12:392–401.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Huggins EL, Stollings JL, Jackson JC, Sevin CM. Models for a Post-Intensive Care Syndrome Clinic – Targeted Goals and Barriers. In: SCCM.org. http://www.sccm.org/Communications/Critical-Connections/Archives/Pages/Models-for-a-Post-Intensive-Care-Syndrome-Clinic%2D%2D-Targeted-Goals-and-Barriers.aspx. Accessed 18 Feb 2018.

  7. Rehabilitation after critical illness in adults | guidance ... nice.org.uk/guidance/qs158. Accessed 18 Feb 2018.

  8. Coughlin MT, Angus DC. Economic evaluation of new therapies in critical illness. Crit Care Med. 2003;31:S7. https://doi.org/10.1097/00003246-200301001-00002.

    Article  PubMed  Google Scholar 

  9. WHO. Making choices in health WHO guide to cost-effectiveness analysis. Geneva: World Health Organization; 2003.

    Google Scholar 

  10. Griffiths J, Hatch RA, Bishop J, Morgan K, Jenkinson C, Cuthbertson BH, Brett SJ. An exploration of social and economic outcome and associated health-related quality of life after critical illness in general intensive care unit survivors: a 12-month follow-up study. Crit Care. 2013;17:R100. https://doi.org/10.1186/cc12745.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Quasim T, et al. Employment, social dependency and return to work after intensive care. J Intens Care Soc. 2015;16(1):31–6.

    Article  Google Scholar 

  12. WHO (1970) The first ten years of the World Health Organization. In: apps.who.int. http://apps.who.int/iris/handle/10665/37089. Accessed 18 Feb 2018.

  13. Spliker B. Quality of life and pharmacoeconomics in clinical trials. Philadelphia: Lippincott Williams & Wilkins; 1996.

    Google Scholar 

  14. Wu A, Gao F. Long-term outcomes in survivors from critical illness. Anaesthesia. 2004;59:1049–52.

    Article  CAS  PubMed  Google Scholar 

  15. Lins L, Carvalho FM. SF-36 total score as a single measure of health-related quality of life: scoping review. SAGE Open Med. 2016;4:205031211667172.

    Article  Google Scholar 

  16. van Reenen M, Janssen B. EQ-5D-5L User Guide – EuroQol. https://euroqol.org/wp-content/uploads/2016/09/EQ-5D-5L_UserGuide_2015.pdf. Accessed 18 Feb 2018.

  17. Whitehead SJ, Ali S. Health outcomes in economic evaluation: the QALY and utilities. Br Med Bull. 2010;96:5–21.

    Article  PubMed  Google Scholar 

  18. Cuthbertson BH, Roughton S, Jenkinson D, Maclennan G, Vale L. Quality of life in the five years after intensive care: a cohort study. Crit Care. 2010;14:R6. https://doi.org/10.1186/cc8848.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Cohen DJ, Reynolds MR. Interpreting the results of cost-effectiveness studies. J Am Coll Cardiol. 2008;52:2119–26.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Neumann PJ, Cohen JT, Weinstein MC. Updating cost effectiveness – the curious resilicience of the $50,000-per-QALY threshold. N Engl J Med. 2014;371:796. https://doi.org/10.1056/NEJMp1405158.

    Article  CAS  PubMed  Google Scholar 

  21. Judging whether public health interventions offer value for money. In: Guidance and guidelines | NICE. http://www.nice.org.uk/guidance/lgb10. Accessed 18 Feb 2018.

  22. Nimdet K, Chaiyakunapruk N, Vichansavakul K, Ngorsuraches S. A systematic review of studies eliciting willingness-to-pay per quality-adjusted life year: does it justify CE threshold? PLoS One. 2015;10:e0122760. https://doi.org/10.1371/journal.pone.0122760.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. WHO Macroeconomics and health. Investing in health for economic development. Report of the commision on macroeconomics and health. In: http://www1.worldbank.org/publicsector/pe/PEAMMarch2005/CMHReport.pdf. Accessed 18 Feb 2018.

  24. Griffiths JA, Gager M, Waldmann C. Follow-up after intensive care. Conti Educ Anaesth Crit Care Pain. 2004;4:202–5.

    Article  Google Scholar 

  25. Jones C, Skirrow P, Griffiths RD, Humphris GH, Ingleby S, Eddleston J, Waldmann C, Gager M. Rehabilitation after critical illness: a randomized, controlled trial. Crit Care Med. 2003;31:2456–61.

    Article  PubMed  Google Scholar 

  26. Schandl A, Bottai M, Hellgren E, Sundin Ö, Sackey P. Gender differences in psychological morbidity and treatment in intensive care survivors – a cohort study. Crit Care. 2012;16:R80. https://doi.org/10.1186/cc11338.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Cuthbertson BH, Rattray J, Campbell MK, Gager M, Roughton S, Smith A, et al. The PRaCTICaL study of nurse led, intensive care follow-up programmes for improving long term outcomes from critical illness: a pragmatic randomised controlled trial. BMJ. 2009;339:b3723.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Walsh TS, Salisbury LG, Merriweather JL, et al. Increased hospital-based physical rehabilitation and information provision after intensive care unit discharge. JAMA Intern Med. 2015;175:901.

    Article  PubMed  Google Scholar 

  29. Hermans G, Berghe GVD. Clinical review: intensive care unit acquired weakness. Crit Care. 2015;19:274. https://doi.org/10.1186/s13054-015-0993-7.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Griffith DM, Lewis S, Rossi AG, Rennie J, Salisbury L, Merriweather JL, Templeton K, Walsh TS. Systemic inflammation after critical illness: relationship with physical recovery and exploration of potential mechanisms. Thorax. 2016;71:820–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to B. H. Cuthbertson .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 European Society of Intensive Care Medicine

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Willaert, X., Vijayaraghavan, B.K.T., Cuthbertson, B.H. (2020). Cost-Effectiveness of Postintensive Care Clinics. In: Preiser, JC., Herridge, M., Azoulay, E. (eds) Post-Intensive Care Syndrome. Lessons from the ICU. Springer, Cham. https://doi.org/10.1007/978-3-030-24250-3_26

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-24250-3_26

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-24249-7

  • Online ISBN: 978-3-030-24250-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics