Variable costs of ICU patients: a multicenter prospective study.
OBJECTIVE
To analyze the costs of treating critically ill patients.


METHODS
Multicenter, observational, prospective, cohort, bottom-up study on variable costs in 51 ICUs.


METHODS
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.


METHODS
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).


RESULTS
Median costs for a multiple trauma patient were euro 4076 and for coronary surgery patient euro 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.
Rossi
Carlotta
C
Centro di Ricerche Cliniche per le Malattie Rare Aldo e Cele Daccò, Istituto di Ricerche Farmacologiche Mario Negri, Ranica, Italy.
Simini
Bruno
B
Brazzi
Luca
L
Rossi
Giancarlo
G
Radrizzani
Danilo
D
Iapichino
Gaetano
G
Bertolini
Guido
G
D000293:Adolescent; D015331:Cohort Studies; D003365:Costs and Cost Analysis / Q000379:methods; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000191:economics*; D007558:Italy / Q000453:epidemiology; D011446:Prospective Studies