Cost-Effectiveness Studies in the ICU
| Autor: | M. Elizabeth Wilcox, Peter J. Neumann, Chaim M. Bell, Kelsey Vaughan, Christopher A K Y Chong |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
business.industry Cost effectiveness medicine.medical_treatment Psychological intervention 030208 emergency & critical care medicine Critical Care and Intensive Care Medicine Checklist 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Health care Cohort Medicine Resource allocation Healthcare cost Renal replacement therapy business Intensive care medicine health care economics and organizations |
| Zdroj: | Critical Care Medicine. 47:1011-1017 |
| ISSN: | 0090-3493 |
| Popis: | OBJECTIVES Cost-effectiveness analyses are increasingly used to aid decisions about resource allocation in healthcare; this practice is slow to translate into critical care. We sought to identify and summarize original cost-effectiveness studies presenting cost per quality-adjusted life year, incremental cost-effectiveness ratios, or cost per life-year ratios for treatments used in ICUs. DESIGN We conducted a systematic search of the English-language literature for cost-effectiveness analyses published from 1993 to 2018 in critical care. Study quality was assessed using the Drummond checklist. SETTING Critical care units. PATIENTS OR SUBJECTS Critical care patients. INTERVENTIONS Identified studies with cost-effectiveness analyses. MEASUREMENTS AND MAIN RESULTS We identified 97 studies published through 2018 with 156 cost-effectiveness ratios. Reported incremental cost-effectiveness ratios ranged from -$119,635 (hypothetical cohort of patients requiring either intermittent or continuous renal replacement therapy) to $876,539 (data from an acute renal failure study in which continuous renal replacement therapy was the most expensive therapy). Many studies reported favorable cost-effectiveness profiles (i.e., below $50,000 per life year or quality-adjusted life year). However, several therapies have since been proven harmful. Over 2 decades, relatively few cost-effectiveness studies in critical care have been published (average 4.6 studies per year). There has been a more recent trend toward using hypothetical cohorts and modeling scenarios without proven clinical data (2014-2018: 19/33 [58%]). CONCLUSIONS Despite critical care being a significant healthcare cost burden there remains a paucity of studies in the literature evaluating its cost effectiveness. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|