title: A prospective audit of costs of intensive care in cancer patients in India.
abstract: BACKGROUND
  The costs of healthcare are increasing. Intensive care poses largest burden on the hospital budget, even in developed countries. We attempted to find out the costs of intensive care in an Indian cancer hospital.
  
  
  METHODS
  Cost data was prospectively collected for patient-related and non-patient-related activities in a mixed surgical, medical cancer ICU. Demographic data, source, reason, and length of ICU stay were recorded. Total per day costs, costs for patients admitted from wards and operating rooms, and effective cost per survivor (ECPS) were calculated.
  
  
  RESULTS
  Data was collected for 101 consecutive ICU patients. Fifty-five patients were admitted after surgery (total patient hours 3485 i.e., 145.21 patient days). The mean (SD) intensive care unit length of stay (ICU LOS) was 64.84 (58.47) hrs. (8.25 to 552). Fifty-three patients survived to discharge. Forty-six patients were admitted from wards (hematooncology) or casualty and stayed 3980.25 patient hrs (165.84 patient days). The mean (SD, range) ICU LOS was 106.84 (64.05, 1-336) hrs. Of these, 26 patients survived to discharge. The effective cost per survivor (ECPS) was significantly higher for patients admitted from wards. [Rs. 83,558 = 00 (USD 1856.84) vs. Rs. 15,049 = 00 (USD 334.42)].
  
  
  CONCLUSIONS
  The costs of ICU place much higher burden on the patients as the Indian GDP and per capita income is much lower. Better selection process is needed for hemato-oncology patients for ICU admission for better utilization of scarce resources. Such data as ours can be used to inform families and physicians about anticipated costs.
authors: Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Dr. E. Borges Road, Parel, Mumbai, India.
authors: Atul P
authors: AP
authors: Kulkarni
authors: Jigeeshu V
authors: JV
authors: Divatia
keywords: Cost analysis; costs; effective cost per survivor; health economics; intensive care; length of stay