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2015, Number 3

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Med Crit 2015; 29 (3)

Variables associated costs in intensive care

Rodríguez-Montoya R, Sandoval-Oliva V, Cabrejo-Paredes J, Chacón-Angulo N, Chiquinta-Ramos G, Rodríguez-Montoya M

Language: Spanish
References: 24
Page: 138-144
PDF size: 213.66 Kb.


ABSTRACT

Objective: To determine whether the variables gender, age, survival, use of mechanical ventilation, septic shock and survival scores [Acute Physiology and Chronic Health Evaluation (APACHE II), Simplified Acute Physiology Score II (SPAS II), Sequential Organ Failure Assessment (SOFA) and Scoring System Therapeutic Intervention 28 (TISS 28)] are related to the costs in the Intensive Care Unit (ICU).
Material and methods: Descriptive, prospective, comparative study of costs made to patients admitted to the ICU from January to June 2013; sought if these variables are related to costs.
Results: They are statistically related to higher costs: age with the cost of stay or total costs (p = 0.004), male gender with total costs (p = 0.04), no survivors with the daily cost (p = 0.0001), use of mechanical ventilation with the daily cost (p = 2.77E-12) and total cost (p = 7.23E-09), septic shock with the daily cost (p = 6.07E-06) and total cost (p = 3.65E-05), APACHE II score with the daily cost (p = 0.01), SPAS II with the daily cost (p = 0.006) and total cost (p = 0.007), SOFA with the daily cost (p = 0.0008) and total cost (p = 0.02) and each TISS 28 point costs € 25.
Conclusion: The variables age, male gender, non-survivors, use of mechanical ventilation, septic shock and APACHE II, SPAS II, SOFA Scores are related to increased costs in UCI; TISS 28 costs € 25 per point.


REFERENCES

  1. Medicina Intensiva y las Unidades de Cuidados Intensivos Definición-Desarrollo Histórico-Utilización de sus Recursos. [En línea]. Honduras. Revista Médica Hondureña. Perdomo R; 1992. [Consultado 20 ene 2014]. [4p.]. Disponible en: http://www.bvs.hn/RMH/pdf/1992/pdf/Vol60-1-1992-13.pdf

  2. Elguea E, Cerón U, Esponda J, Cabrera R. Calidad y costo-efectividad en la atención del paciente Crítico. Rev Asoc Mex Med Crit y Ter Int. 2012;26:42-50.

  3. Flaatten H, Kvale R. Cost of intensive care in a Norwegian. University Hospital 1997-1999. Crit Care. 2003;7:72-78.

  4. Indicadores de calidad en el enfermo crítico actualización 2011. [En línea]. España. Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias; 2011 [Consultado 20 ene 2014]. [188 p.]. Disponible en: http://www.semicyuc.org/sites/default/files/actualizacion_indicadores_calidad_2011.pdf

  5. Alvear S, Canteros J, Rodríguez P. Estudio retrospectivo de costos de tratamientos intensivos por paciente y día cama. Rev Med Chile. 2010;138:558-566.

  6. Iñigo J, Sendra JM, Díaz R, Bouza C, Sarría-Santamera A. Epidemiology and costs of severe sepsis in Madrid. A hospital discharge study. Med Intensiva. 2006;30(5):197-203.

  7. Lee H, Doig CJ, Ghali WA, Donaldson C, Johnson D, Manns B. Detailed cost analysis of care for survivors of severe sepsis. Crit Care Med. 2004;32(4):981-985.

  8. Angus D, Linde-Zwirble W, Lidicker J, Clermont G, Carcillo J, Pinsky M. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. University of Pittsburgh, USA. Crit Care Med. 2001;29(7):1303-1310.

  9. Moerer O, Schmid A, Hofmann M, Herklotz A, Reinhart K, Werdan K, et al. Direct costs of severe sepsis in three German intensive care units based on retrospective electronic patient record analysis of resource use. Intensive Care Med. 2002;28(10):1440-1446.

  10. Dasta J, McLaughlin T, Mody S, Piech C. Daily cost of an intensive care unit day: the contribution of mechanical ventilation. Rev Care Med. 2005;33(6):1266-1271.

  11. Edbrooke DL, Hibbert CL, Kingsley JM, Smith S, Bright NM, Quinn JM. The patient-related costs of care for sepsis patients in a United Kingdom adult general intensive care unit. Crit Care Med. 1999;27(9):1760-1777.

  12. Graf J, Graf C, Janssens U. Analysis of resource use and cost-generating factors in a German medical intensive care unit employing the Therapeutic Intervention Scoring System (TISS-28). Intensive Care Med. 2002;28(3):324-331.

  13. Le Gall JR, Lemeshow S, Saulnier F. A New Simplified Acute Physiology Score (SAPS II) Based on a European/North American Multicenter Study. JAMA. 1993;270(24):2975-2963.

  14. Vincent J, de Mendonça A, Cantraine F, Moreno R, Takala J, Suter P, et al. Use of the SOFA score to assess the incidence of organ dysfunction/ failure in intensive care units: results of a multicenter, prospective study. Working group on “sepsis-related problems” of the European Society of Intensive Care Medicine. Crit Care Med. 1998;26(11):1793-1800.

  15. Moerer O, Plock E, Mgbor U, Schmid A, Schneider H, Wischnewsky MB, et al. A German national prevalence study on the cost of intensive care: an evaluation from 51 Intensive Care Units. Crit Care. 2007;11(3):R69.

  16. Knaus WA, Draper EA, Wagner DP and Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13(10):818-829.

  17. Adrie C, Alberti C, Chaix-Couturier C, Azoulay E, De Lassence A, Cohen Y, et al. Epidemiology and economic evaluation of severe sepsis in France: age, severity, infection site, and place of acquisition (community, hospital, or intensive care unit) as determinants of workload and cost. Delafontaine Hospital, Saint Denis, France. J Crit Care. 2005;20(1):46-58.

  18. Costos y resultados de los pacientes críticos en el Servicio de Emergencia del Hospital Guillermo Almenara Irigoyen-EsSalud [en línea]. Perú. Universidad Nacional Mayor de San Marcos, Facultad de Medicina, Unidad de Postgrado. Barreto O. 2004. [Consultado 20 ene 2014]. [58 p.]. http://cybertesis.unmsm.edu.pe/handle/cybertesis/2043

  19. Sánchez VLD. Análisis de costos en las Unidades de Terapia Intensiva mexicanas. Estudio multicéntrico. Rev Asoc Mex Med Crit y Ter Int. 2010;25(2):159-166.

  20. Alvear S, Canteros J, Jara J, Rodríguez P, Mujica V. Determinación y análisis de costos reales de tratamientos intensivos por paciente y día cama. Revista Chilena de Medicina Intensiva. 2012;27(1):7-14.

  21. Rossi C, Simini B, Rossi G, Radriazzani D, Lapichino G, Bertolini G. Gruppo italiano per la valutazione degli interventi in terapia intensiva. Variable costs of ICU patients: a multicenter prospective study. Intensive Care Med. 2006;32(4):545-552.

  22. Brun-Buisson C, Roudot-Thoraval F, Girou E, Grenier-Sennelier C, Durand-Zalesky I. The costs of septic syndromes in the intensive care unit and influence of hospital – acquired sepsis. Intensive Care Med. 2003;20(9):1464-1471.

  23. Burchardi H, Schneider H. Economic aspects of severe sepsis: a review of Intensive Care Unit costs, cost of illness and cost effectiveness of therapy. Germany. Pharmacoeconomics. 2004;22(12):793-813.

  24. Carrasco G, Pallarés A, Cabré L. Costes de la calidad en Medicina Intensiva. Guía para gestores clínicos. Med Intensiva. 2006;30(4):167-179.




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