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Intensive Care Medicine

, Volume 27, Issue 1, pp 146–153 | Cite as

A cost-effectiveness analysis of stays in intensive care units

  • M. Sznajder
  • P. Aegerter
  • R. Launois
  • Y. Merliere
  • B. Guidet
  • V. CubRea
Original

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.

Intensive care Health-care costs Resource allocation Hospital costs Cost-benefit analysis Quality-adjusted life-years EuroQol 

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Copyright information

© Springer-Verlag 2000

Authors and Affiliations

  • M. Sznajder
    • 1
  • P. Aegerter
    • 1
  • R. Launois
    • 2
  • Y. Merliere
    • 3
  • B. Guidet
    • 4
  • V. CubRea
    • 5
  1. 1.Department of Public Health and Medical Informatics, Hospital Ambroise Paré, 9 avenue Charles de Gaulle, 92100 Boulogne, FranceFrance
  2. 2.Department of Public Health and Health Economics, Université Paris XIII, 74 rue Marcel Cachin, 93017 Bobigny, FranceFrance
  3. 3.Financial Department, Assistance Publique–Hôpitaux de Paris, 4 avenue Victoria, 75001 Paris, FranceFrance
  4. 4.Department of intensive care, Hospital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75012 Paris, FranceFrance
  5. 5.College of Database Users in Intensive Care, Hospital Ambroise Paré, 9 avenue Charles de Gaulle, 92100 Boulogne, FranceFrance

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