title: Variable cost of ICU care, a micro-costing analysis.
abstract: Intensive care unit (ICU) costs account for a great part of a hospital's expenses. The objective of the present study was to measure the patient-specific cost of ICU treatment, to identify the most important cost drivers in ICU and to examine the role of various contributing factors in cost configuration. A retrospective cost analysis of all ICU patients who were admitted during 2011 in a Greek General, seven-bed ICU and stayed for at least 24hours was performed, by applying bottom-up analysis. Data collected included demographics and the exact cost of every single material used for patients' care. Prices were yielded from the hospital's purchasing costs and from the national price list of the imaging and laboratory tests, which was provided by the Ministry of Health. A total of 138 patients were included. Variable cost per ICU day was €573.18. A substantial cost variation was found in the total costs obtained for individual patients (median: €3443, range: €243.70-€116,355). Medicines were responsible for more than half of the cost and antibiotics accounted for the largest part of it, followed by blood products and cardiovascular drugs. Medical cause of admission, severe illness and increased length of stay, mechanical ventilation and dialysis were the factors associated with cost escalation. ICU variable cost is patient-specific, varies according to each patient's needs and is influenced by several factors. The exact estimation of variable cost is a pre-requisite in order to control ICU expenses.
authors.affiliation: University ICU, Ag. Anargiroi General Hospital, Kaliftaki 41, 14564 Kiffissia, Greece. Electronic address: dekara66@gmail.com.
authors.forename: Dimitra
authors.initials: D
authors.lastname: Karabatsou
authors.affiliation: University of Peloponissos, 23100 Sparti, Greece. Electronic address: tsironi@uop.gr.
authors.forename: Maria
authors.initials: M
authors.lastname: Tsironi
authors.affiliation: University ICU, Ag. Anargiroi General Hospital, Kaliftaki 41, 14564 Kiffissia, Greece. Electronic address: evitsigou@yahoo.com.
authors.forename: Evdoxia
authors.initials: E
authors.lastname: Tsigou
authors.affiliation: University ICU, Ag. Anargiroi General Hospital, Kaliftaki 41, 14564 Kiffissia, Greece. Electronic address: raptakel@yahoo.gr.
authors.forename: Eleni
authors.initials: E
authors.lastname: Boutzouka
authors.affiliation: Nursing Department, National and Kapodistrian University of Athens, Greece; University ICU, Ag. Anargiroi General Hospital, Kaliftaki 41, 14564 Kiffissia, Greece. Electronic address: tkatsoul@nurs.uoa.gr.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Katsoulas
authors.affiliation: Nursing Department, National and Kapodistrian University of Athens, Greece; University ICU, Ag. Anargiroi General Hospital, Kaliftaki 41, 14564 Kiffissia, Greece. Electronic address: gbaltop@nurs.uoa.gr.
authors.forename: George
authors.initials: G
authors.lastname: Baltopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis / Q000379:methods* / Q000706:statistics & numerical data; D003422:Critical Care / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Bottom-up cost analysis; Cost; Costing methodologies; Intensive care; Top-down cost analysis; Variable cost