Economic burden of illness imposed by severe sepsis in Austria.
BACKGROUND
Sepsis is a life-threatening disease, requiring instant treatment in an intensive care unit (ICU). The aim of this study was to determine the direct and indirect costs occurring in Austria due to this disease.


METHODS
Direct costs were calculated based on a retrospective chart analysis in four adult Austrian ICUs, evaluating 74 patient records from the years 2000/2001. Patients were identified to have suffered from severe sepsis using ACCP-definitions. Assessed resource use (medication, laboratory analysis, microbiology analysis, consumer-goods, diagnostic procedures, staff costs, and basic bed costs) was linked with related center specific costs to determine direct costs per patient. Indirect costs due to productivity losses were calculated using official statistical material.


RESULTS
The mean length of ICU stay (LOS ICU) of a severely septic patient was 18.1 days. Overall ICU mortality was found to be 43.2% and showed no gender difference. The mean daily direct ICU costs of care for severely septic patients were [symbol: see text] 1,617 and the mean total direct ICU costs per septic patient were [symbol: see text] 28,582. In total costs, survivors were equally expensive as non-survivors ([symbol: see text] 28,699 vs. 28,463) although their length of study was considerably longer (21.9 vs. 13.2 days). Considering a range of patients with severe sepsis in Austria from 6,700 to 9,500 per year, total direct costs in Austria range from [symbol: see text] 192 million to [symbol: see text] 272 million. Indirect costs determined by productivity losses due to unfitness for work (temporary and permanent) and premature death amount to [symbol: see text] 484 million to [symbol: see text] 686 million in Austria per year (same incidence range). Total costs, i.e. burden of illness, combining direct costs with indirect costs, range from [symbol: see text] 676 million to [symbol: see text] 958 million.


CONCLUSIONS
Patients with severe sepsis have a high mortality rate, spend prolonged periods of time in the ICU, and are expensive to treat. Indirect costs of severe sepsis due to productivity losses, particularly by premature death, are considerable.
Schmid
Alexandra
A
HealthEcon AG, Basel, Switzerland.
Schneider
Heinz
H
Adlof
Astrid
A
Smolle
Karl-Heinz
KH
Edelmann
Günther
G
Sporn
Paul
P
Frass
Michael
M
Sumann
Günther
G
Koller
Wolfgang
W
Schobersberger
Wolfgang
W
D000328:Adult; D000368:Aged; D001317:Austria; D003365:Costs and Cost Analysis; D003422:Critical Care / Q000191:economics; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources / Q000191:economics; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D012189:Retrospective Studies; D016019:Survival Analysis; D018746:Systemic Inflammatory Response Syndrome / Q000191:economics* / Q000401:mortality