Costs of Australian intensive care: A systematic review

IF 1.4 4区 医学 Q3 CRITICAL CARE MEDICINE Critical Care and Resuscitation Pub Date : 2024-06-01 DOI:10.1016/j.ccrj.2024.03.003
Alayna Carrandi MPH , Cheelim Liew DNP , Matthew J. Maiden PhD , Edward Litton PhD , Colman Taylor PhD , Kelly Thompson PhD , Alisa Higgins PhD
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Abstract

Objective

Intensive care unit (ICU) cost estimates are critical to achieving healthcare system efficiency and sustainability. We aimed to review the published literature describing ICU costs in Australia.

Design

A systematic review was conducted to identify studies that estimated the cost of ICU care in Australia. Studies conducted in specific patient cohorts or on specific treatments were excluded.

Data sources

Relevant studies were sourced from a previously published review (1970–2016), a systematic search of MEDLINE and EMBASE (2016–5 May 2023), and reference checking.

Review methods

A tool was developed to assess study quality and risk of bias (maximum score 57/57). Total and component costs were tabulated and indexed to 2022 Australian Dollars. Costing methodologies and study quality assessments were summarised.

Results

Six costing studies met the inclusion criteria. Study quality scores were low (15/41 to 35/47). Most studies were conducted only in tertiary metropolitan public ICUs; sample sizes ranged from 100 to 10,204 patients. One study used data collected within the past 10 years. Mean daily ICU costs ranged from $966 to $5381 and mean total ICU admission costs $4888 to $14,606. Three studies used a top-down costing approach, deriving cost estimates from budget reports. The other three studies used both bottom-up and top-down costing approaches. Bottom-up approaches collected individual patient resource use.

Conclusions

Available ICU cost estimates are largely outdated and lack granular data. Future research is needed to estimate ICU costs that better reflect current practice and patient complexity and to determine the best methods for generating these estimates.

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澳大利亚重症监护的成本:系统回顾
目的重症监护病房(ICU)的成本估算对于实现医疗系统的效率和可持续性至关重要。我们旨在回顾已发表的有关澳大利亚重症监护病房成本的文献。数据来源相关研究来自之前发表的综述(1970-2016 年)、MEDLINE 和 EMBASE 的系统检索(2016 年 5 月至 2023 年 5 月)以及参考文献核对。综述方法开发了一种工具来评估研究质量和偏倚风险(最高分 57/57)。将总成本和各部分成本制成表格,并将其指数化为 2022 澳元。结果六项成本计算研究符合纳入标准。研究质量得分较低(15/41 至 35/47)。大多数研究仅在三级城市公立重症监护病房进行;样本量从 100 到 10,204 名患者不等。其中一项研究使用了过去 10 年内收集的数据。重症监护室的平均每日成本从 966 美元到 5381 美元不等,平均入院总成本从 4888 美元到 14606 美元不等。三项研究采用了自上而下的成本计算方法,从预算报告中得出成本估算。另外三项研究同时采用了自下而上和自上而下的成本计算方法。结论现有的重症监护室成本估算大多已经过时,而且缺乏细化数据。未来的研究需要估算出能更好地反映当前实践和患者复杂性的重症监护室成本,并确定产生这些估算值的最佳方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Critical Care and Resuscitation
Critical Care and Resuscitation CRITICAL CARE MEDICINE-
CiteScore
7.70
自引率
3.40%
发文量
44
审稿时长
>12 weeks
期刊介绍: ritical Care and Resuscitation (CC&R) is the official scientific journal of the College of Intensive Care Medicine (CICM). The Journal is a quarterly publication (ISSN 1441-2772) with original articles of scientific and clinical interest in the specialities of Critical Care, Intensive Care, Anaesthesia, Emergency Medicine and related disciplines. The Journal is received by all Fellows and trainees, along with an increasing number of subscribers from around the world. The CC&R Journal currently has an impact factor of 3.3, placing it in 8th position in world critical care journals and in first position in the world outside the USA and Europe.
期刊最新文献
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