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  1. Is it'worthwhile'to continue treating patients with a prolonged stay (>14 days) in the ICU ? An economic evaluation.

    Article - En anglais

    Objective 

    To compare the cost and consequences of a policy of continuing to care for patients with a prolonged stay in the ICU with a proposed policy of withdrawing support.

    Design 

    Economic evaluation using data derived from a prospective cohort study.

    Setting 

    Adult medical/surgical ICU in a tertiary care hospital.

    Patients 

    Consecutive patients admitted to the ICU.

    Intervention 

    None.

    Main outcome measures 

    We performed a cost-accounting analysis on each patient in the ICU and followed up patients until 12 months after admission to ICU and assessed components of quality of life in survivors.

    Results 

    During the study period, 690 patients were admitted to the ICU.

    Only 61 (9%) patients remained in the ICU for>14 days.

    For this group, the mean length of stay in the ICU was 24.5 (±11.7) days and duration in hospital was 57.9 (±56.9) days.

    At 12 months, 27 (44%) were alive.

    Overall, the mean quality of life score at 12 months did not differ between patients with a short or prolonged stay in the ICU.

    The average ICU cost per day per patient was $1,565 (Canadian) resulting in a total cost for the whole cohort of Can $1,917,382.

    Over the same time period, 58 patients had life support withdrawn.

    On average, patients survived another day in the ICU, 2 more days in hospital, and all patients ultimately died.

    When treatment was discontinued, the costs of treating this cohort was Can $156,465. (...)

    Mots-clés Pascal : Hospitalisation, Longue durée, Service hospitalier, Analyse, Coût, Qualité vie, Etude longitudinale, Homme, Réanimation cardiocirculatoire, Appareil circulatoire pathologie, Etude économique

    Mots-clés Pascal anglais : Hospitalization, Long lasting, Hospital ward, Analysis, Costs, Quality of life, Follow up study, Human, Intensive cardiocirculatory care, Cardiovascular disease, Economic study

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0357385

    Code Inist : 002B27B01. Création : 25/01/1999.