title: The daily cost of ICU patients: A micro-costing study in 23 French Intensive Care Units.
abstract: OBJECTIVE
  To estimate the daily cost of intensive care unit (ICU) stays via micro-costing.
  
  
  METHODS
  A multicentre, prospective, observational, cost analysis study was carried out among 21 out of 23 French ICUs randomly selected from French National Hospitals. Each ICU randomly enrolled 5 admitted adult patients with a simplified acute physiology II score ≥ 15 and with at least one major intensive care medical procedure. All health-care human resources used by each patient over a 24-hour period were recorded, as well as all medications, laboratory analyses, investigations, tests, consumables and administrative expenses. All resource costs were estimated from the hospital's perspective (reference year 2009) based on unitary cost data.
  
  
  RESULTS
  One hundred and four patients were included (mean age: 62.3 ± 14.9 years, mean SAPS II: 51.5 ± 16.1, mean SOFA on the study day: 6.9 ± 4.3). Over 24 hours, 29 to 186 interventions per patient were performed by different caregivers, leading to a mean total time spent for patient care of 13:32 ± 05:00 h. The total daily cost per patient was € 1425 ± € 520 (95% CI = € 1323 to € 1526). ICU human resources represented 43% of total daily cost. Patient-dependent expenses (€ 842 ± € 521) represented 59% of the total daily cost. The total daily cost was correlated with the daily SOFA score (r = 0.271, P = 0.006) and the bedside-time given by caregivers (r = 0.716, P < 0.0001).
  
  
  CONCLUSIONS
  The average cost of one day of ICU care in French National Hospitals is strongly correlated with the duration of bedside-care carried out by human resources.
authors.affiliation: Division anesthésie réanimation douleur urgences, faculté de médecine, université Montpellier 1, CHU de Nîmes, place du Professeur-Robert-Debré, 30029 Nîmes cedex 9, France. Electronic address: jean.yves.lefrant@chu-nimes.fr.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Lefrant
authors.affiliation: Service de réanimation et de surveillances médico-chirurgicales polyvalentes, centre hospitalier du Pays d'Aix, Aix-en-Provence, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Garrigues
authors.affiliation: Health Outcomes Department, GlaxoSmithKline, 100, route de Versailles, 78163 Marly-le-Roi cedex, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Pribil
authors.affiliation: IMS Health, Health Economics and Outcomes Research Department, Tour Ariane, 5-7, place de la Pyramide, 92088 La Défense cedex, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bardoulat
authors.affiliation: IMS Health, Health Economics and Outcomes Research Department, Tour Ariane, 5-7, place de la Pyramide, 92088 La Défense cedex, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Courtial
authors.affiliation: IMS Health, Health Economics and Outcomes Research Department, Tour Ariane, 5-7, place de la Pyramide, 92088 La Défense cedex, France.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Maurel
authors.affiliation: Service anesthésie réanimation, CHU de Clermont-Ferrand, 1, place Lucile-Aubrac, 63003 Clermont-Ferrand cedex, France.
authors.forename: Jean-Étienne
authors.initials: JÉ
authors.lastname: Bazin
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000191:economics; D003365:Costs and Cost Analysis; D003422:Critical Care / Q000191:economics*; D016527:Drug Costs; D005260:Female; D005602:France; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007362:Intensive Care Units / Q000191:economics*; D007755:Laboratories, Hospital / Q000191:economics; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
keywords: Cost; ICU