COST OF INTENSIVE CARE IN INDIA
| Autor: | Lakshmanan Jeyaseelan, John Victor Peter, Bijesh Yadav, K. R. John, Thomas Isiah Sudarsan, Thomas K, Thambu David Sudarsanam, Anna Revathi, Jony Christina |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Critical Illness India Hospitals Private law.invention 03 medical and health sciences Indirect costs 0302 clinical medicine Willingness to pay law Intensive care Humans Medicine Hospital Mortality Prospective Studies 030212 general & internal medicine Medical diagnosis APACHE Health economics business.industry Health Policy 030208 emergency & critical care medicine Subsidy Length of Stay Middle Aged Hospital Charges Respiration Artificial Intensive care unit Confidence interval Intensive Care Units Socioeconomic Factors Emergency medicine Costs and Cost Analysis Female business |
| Zdroj: | International Journal of Technology Assessment in Health Care. 32:241-245 |
| ISSN: | 1471-6348 0266-4623 |
| Popis: | Objectives: The majority of patients in India access private sector providers for curative medical services. However, there is scanty information on the cost of treatment of critically ill patients in this setting. The study evaluates the cost and extent of financial subsidy required for patients admitted to an intensive care unit (ICU) in India.Methods: Data on direct medical, direct nonmedical, and indirect cost were prospectively collected from critically ill patients admitted to a tertiary teaching hospital in India. Willingness-to-pay (WTP) amount was obtained from the next-of-kin following admission and the actual cost paid by the family at discharge was recorded.Results: The main diagnoses (n = 499) were infection (26 percent) and poisoning (21 percent). The mean APACHE-II score was 13.9 (95 percent confidence interval [CI], 13.3–14.5); 86 percent were ventilated. ICU stay was 7.8 days (95 percent CI, 7.3–8.3). Hospital mortality was 27.9 percent. Direct medical cost accounted for 77 percent (US$ 2164) of the total treatment cost (US$ 2818). Indirect cost and direct nonmedical cost contributed to 19 percent (US$ 547.5) and 4 percent (US$ 106.5), respectively. Average total and daily ICU cost were US$ 1,897 and US$ 255, respectively. Although the family's WTP was 53 percent (US$ 1146; 95 percent CI, 1090–1204) of direct medical cost, their final contribution was 67.7 percent (US$ 1465; 95 percent CI, 1327–1604).Conclusions: The cost of an ICU admission in our setting is US$ 2818. Although the family's contribution to expenses exceeded their initial WTP, a substantial subsidy (33 percent) is still required. Alternate financing strategies for the poor and optimization of ICU resources are urgently required. |
| Databáze: | OpenAIRE |
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