title: Hospital Costs Of Extracorporeal Life Support Therapy.
abstract: OBJECTIVE
  To conduct an exploration of the hospital costs of extracorporeal life support therapy. Extracorporeal life support seems an efficient therapy for acute, potentially reversible cardiac or respiratory failure, when conventional therapy has been inadequate, or as bridge to transplant, but unfortunately, no evidence in randomized controlled trials is delivered yet.
  
  
  METHODS
  Single-center retrospective exploratory cohort cost study. The study is performed from a hospital perspective with a time horizon of patients' complete hospital admission in which they received extracorporeal life support.
  
  
  METHODS
  ICU of a university teaching hospital in The Netherlands.
  
  
  METHODS
  All 67 consecutive adult patients who were admitted to the ICU of the University Medical Center Groningen in the period 2010-2013 and received extracorporeal life support treatment.
  
  
  METHODS
  None.
  
  
  RESULTS
  The bottom-up microcosting method was used except when stated otherwise. Medical costs were estimated by multiplying every registered healthcare consumption with unit prices. Unit prices were largely based on Dutch reference prices. For each patient, the personnel costs and material costs were assessed in detail. The costs of extracorporeal life support were differentiated in costs of procedures and costs of daily surcharge of therapy. Procedure-related costs were subdivided in costs of devices and disposables, costs of additional human resources, and surgery hours. The mean total hospital costs were € 106.263 (€ 83.841 to € 126.266) per patient ($145,580). On average, 52% of the total costs arose from hospital nursing days and 11% of direct procedure-related extracorporeal life support costs. Surgery and diagnostics represented a vast amount of the remaining costs.
  
  
  CONCLUSIONS
  This large and detailed economic evaluation of hospital costs of extracorporeal life support therapy in the Netherlands showed that mean total hospital cost of extracorporeal life support treatment is € 106.263 per patient. The majority of the costs are composed of nursing days.
authors.affiliation: 1Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 2Department of Pulmonary Diseases and Lung Transplantation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 3Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 4Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 5Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 6Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Annemieke
authors.initials: A
authors.lastname: Oude Lansink-Hartgring
authors.forename: Berber
authors.initials: B
authors.lastname: van den Hengel
authors.forename: Wim
authors.initials: W
authors.lastname: van der Bij
authors.forename: Michiel E
authors.initials: ME
authors.lastname: Erasmus
authors.forename: Massimo A
authors.initials: MA
authors.lastname: Mariani
authors.forename: Michiel
authors.initials: M
authors.lastname: Rienstra
authors.forename: Vladimir
authors.initials: V
authors.lastname: Cernak
authors.forename: Karin M
authors.initials: KM
authors.lastname: Vermeulen
authors.forename: Walter M
authors.initials: WM
authors.lastname: van den Bergh
mesh_terms: D000328:Adult; D000368:Aged; D003422:Critical Care; D015199:Extracorporeal Membrane Oxygenation / Q000191:economics*; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D012131:Respiratory Insufficiency / Q000191:economics / Q000628:therapy; D012189:Retrospective Studies