Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/22454
Title: Costs and Cost-Utility of Critical Care and Subsequent Health Care: A Multicenter Prospective Study.
Austin Authors: Jukarainen, Sakari;Mildh, Henriikka;Pettilä, Ville;Häkkinen, Unto;Peltola, Mikko;Ala-Kokko, Tero;Reinikainen, Matti;Vaara, Suvi T
Affiliation: Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Centre for Health and Social Economics CHESS, National Institute for Health and Welfare, Helsinki, Finland
Research Group of Surgery, Anesthesiology and Intensive Care Medicine and Medical Research Center, Oulu University Hospital, Oulu University, Oulu, Finland
University of Eastern Finland and Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland
Issue Date: May-2020
metadata.dc.date: 2020-01-10
Publication information: Critical Care Medicine 2020; 48(5): e345-e355
Abstract: The number of critical care survivors is growing, but their long-term outcomes and resource use are poorly characterized. Estimating the cost-utility of critical care is necessary to ensure reasonable use of resources. The objective of this study was to analyze the long-term resource use and costs, and to estimate the cost-utility, of critical care. Prospective observational study. Seventeen ICUs providing critical care to 85% of the Finnish adult population. Adult patients admitted to any of 17 Finnish ICUs from September 2011 to February 2012, enrolled in the Finnish Acute Kidney Injury (FINNAKI) study, and matched hospitalized controls from the same time period. None. We primarily assessed total 3-year healthcare costs per quality-adjusted life-years at 3 years. We also estimated predicted life-time quality-adjusted life-years and described resource use and costs. The costing year was 2016. Of 2,869 patients, 1,839 (64.1%) survived the 3-year follow-up period. During the first year, 1,290 of 2,212 (58.3%) index episode survivors were rehospitalized. Median (interquartile range) 3-year cumulative costs per patient were $49,200 ($30,000-$85,700). ICU costs constituted 21.4% of the total costs during the 3-year follow-up. Compared with matched hospital controls, costs of the critically ill remained higher throughout the follow-up. Estimated total mean (95% CI) 3-year costs per 3-year quality-adjusted life-years were $46,000 ($44,700-$48,500) and per predicted life-time quality-adjusted life-years $8,460 ($8,060-8,870). Three-year costs per 3-year quality-adjusted life-years were $61,100 ($57,900-$64,400) for those with an estimated risk of in-hospital death exceeding 15% (based on the Simplified Acute Physiology Score II). Healthcare resource use was substantial after critical care and remained higher compared with matched hospital controls. Estimated cost-utility of critical care in Finland was of high value.
URI: http://ahro.austin.org.au/austinjspui/handle/1/22454
DOI: 10.1097/CCM.0000000000004210
PubMed URL: 31929342
Type: Journal Article
Appears in Collections:Journal articles

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