Intensive care use in a developing country : a comparison between a Tunisian and a French unit.
To compare the variations in intensive care (ICU) outcome in relation to variations in resources utilization and costs between a developed and a developing country with different medical and economical conditions.
Design and setting
Prospective comparison between a 26-bed French ICU and an 8-bed Tunisian ICU, both in university hospitals.
Four hundred thirty and 534 consecutive admissions, respectively, in the French and Tunisian ICUs.
We prospectively recorded demographic, physiologic. and treatment information for all patients, and collected data on the two ICU structures and facilities.
Costs and ICU outcome were compared in the overall population, in three groups of severity indexes and among selected diagnostic groups.
Tunisian patients were significantly younger, were in better health previously and were less severely ill at ICU admission (p<0.01).
French patients had a lower overall mortality rate (17.2 vs 22.5% ; p<0.01) and received more treatment (p<0.01).
In the low severity range, the outcome and costs were similar in the two countries.
In the highest severity range, Tunisian and French patients had similar mortality rates, while the former received less therapy throughout their ICU stays (p<0.05).
Conversely, in the mid-range of severity, mortality was higher among Tunisian patients, and a difference in management was identified in COPD patients. (...)
Mots-clés Pascal : Soin intensif, Qualité, Utilisation, Pays en développement, Tunisie, Afrique, France, Europe, Analyse coût efficacité, Estimation coût, Mortalité, Ressource, Pronostic, Etude comparative, Evaluation performance, Economie santé, Homme
Mots-clés Pascal anglais : Intensive care, Quality, Use, Developing countries, Tunisia, Africa, France, Europe, Cost efficiency analysis, Cost estimation, Mortality, Resource, Prognosis, Comparative study, Performance evaluation, Health economy, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0027249
Code Inist : 002B30A01C. Création : 31/05/1999.