title: Direct cost analysis of intensive care unit stay in four European countries: applying a standardized costing methodology.
abstract: OBJECTIVE
  The objective of the present study was to measure and compare the direct costs of intensive care unit (ICU) days at seven ICU departments in Germany, Italy, the Netherlands, and the United Kingdom by means of a standardized costing methodology.
  
  
  METHODS
  A retrospective cost analysis of ICU patients was performed from the hospital's perspective. The standardized costing methodology was developed on the basis of the availability of data at the seven ICU departments. It entailed the application of the bottom-up approach for "hotel and nutrition" and the top-down approach for "diagnostics," "consumables," and "labor."
  
  
  RESULTS
  Direct costs per ICU day ranged from €1168 to €2025. Even though the distribution of costs varied by cost component, labor was the most important cost driver at all departments. The costs for "labor" amounted to €1629 at department G but were fairly similar at the other departments (€711 ± 115).
  
  
  CONCLUSIONS
  Direct costs of ICU days vary widely between the seven departments. Our standardized costing methodology could serve as a valuable instrument to compare actual cost differences, such as those resulting from differences in patient case-mix.
authors.affiliation: Institute for Medical Technology Assessment, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands. tan@bmg.eur.nl
authors.forename: Siok Swan
authors.initials: SS
authors.lastname: Tan
authors.forename: Jan
authors.initials: J
authors.lastname: Bakker
authors.forename: Marga E
authors.initials: ME
authors.lastname: Hoogendoorn
authors.forename: Atul
authors.initials: A
authors.lastname: Kapila
authors.forename: Joerg
authors.initials: J
authors.lastname: Martin
authors.forename: Angelo
authors.initials: A
authors.lastname: Pezzi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pittoni
authors.forename: Peter E
authors.initials: PE
authors.lastname: Spronk
authors.forename: Robert
authors.initials: R
authors.lastname: Welte
authors.forename: Leona
authors.initials: L
authors.lastname: Hakkaart-van Roijen
mesh_terms: D000328:Adult; D000368:Aged; D003365:Costs and Cost Analysis; D005060:Europe; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006748:Hospital Departments / Q000191:economics; D006801:Humans; D007362:Intensive Care Units / Q000191:economics*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies