[Economic impact of a prescription protocol in an intensive care unit].
OBJECTIVE
To assess the economic impact of a prescribing protocol for i.v. fluid therapy and artificial nutrition.


METHODS
Comparative study, before and during use of the protocol.


METHODS
The study included 555 ICU patients allocated into two groups, before and after starting with the protocol. The groups were comparable for number, pathologies, age, severity score, duration of ICU stay, incidence of nosocomial infections, mortality rate.


METHODS
In February 1995, a written literature-based prescribing protocol for fluid therapy (hydroxyethylstarch and albumin), and artificial nutrition (enteral nutrition as first-line therapy) was devised. A cost analysis was made for two 6-month periods: before (August 1994 to January 1995) and after start of protocol (February to July 1995).


RESULTS
The prescription of albumin and hydroxyethylstarch decreased (by 33 and 58% respectively), whereas administration of Ringer lactate and gelatine solutes increased simultaneously. This induced a cost saving of 15,000 FF (a 20% decrease in cost). The reduction of parenteral nutrition in favour of early enteral nutrition induced a cost saving of 56,000 FF (31% decrease in cost).


CONCLUSIONS
Our prescribing protocol generated a cost saving of 9% of the pharmaceutical budget and decreased the cost-benefit ratio of our ICU.
Blanc
P
P
Service de réanimation polyvalente, hôpital Font-Pré, Toulon, France.
Gainnier
M
M
Granier
I
I
Guigues
V
V
Boussuges
A
A
Geissler
A
A
Durand-Gasselin
J
J
D000328:Adult; D000368:Aged; D002017:Budgets; D003428:Cross Infection / Q000453:epidemiology; D011307:Drug Prescriptions / Q000191:economics*; D004750:Enteral Nutrition / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D005440:Fluid Therapy / Q000191:economics* / Q000706:statistics & numerical data; D005526:Food, Formulated / Q000191:economics; D005602:France; D017052:Hospital Mortality; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000191:economics; D007362:Intensive Care Units / Q000191:economics*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged
D006895:Hydroxyethyl Starch Derivatives