Abstract
Economic evaluations of interventions in the hospital setting often rely on the estimated long-term impact on patient survival. Estimates of mortality rates and long-term outcomes among patients discharged alive from the intensive care unit (ICU) are lacking from lower- and middle-income countries. This study aimed to assess the long-term survival and life expectancy (LE) amongst post-ICU patients in Thailand, a middle-income country. In this retrospective cohort study, data from a regional tertiary hospital in northeast Thailand and the regional death registry were linked and used to assess patient survival time after ICU discharge. Adult ICU patients aged at least 15 years who had been discharged alive from an ICU between 1 January 2004 and 31 December 2005 were included in the study, and the death registry was used to determine deaths occurring in this cohort up to 31st December 2010. These data were used in conjunction with standard mortality life tables to estimate annual mortality and life expectancy. This analysis included 10,321 ICU patients. During ICU admission, 3,251 patients (31.5%) died. Of 7,070 patients discharged alive, 2,527 (35.7%) were known to have died within the five-year follow-up period, a mortality rate 2.5 times higher than that in the Thai general population (age and sex matched). The mean LE was estimated as 18.3 years compared with 25.2 years in the general population. Post-ICU patients experienced much higher rates of mortality than members of the general population over the five-year follow-up period, particularly in the first year after discharge. Further work assessing Health Related Quality of Life (HRQOL) in both post-ICU patients and in the general population in developing countries is needed.
Highlights
Consistent with Rogers’s theory, interpersonal communication channels are the most important information source, with clinicians, especially GPs, more likely to rely on advice from specialists or pharmaceutical representatives than peer-reviewed publications
As patients cannot observe the effort expended, there is a potential for moral hazard in terms of reduced effort and an increased reliance on pharmaceutical representatives
Electronic medical records (EMRs) in hospitals are potentially beneficial for quality and safety of care, but diffuse slowly
Summary
2003 survey sent to pharmacy managers of 127 hospitals of Ministry of Health(MOH); 67.7% responded; data of 63.7% hospitals were valid for analysis. 19 hospitals were chosen deliberately according to their level of development, their data was tested against selected criteria. 2003 survey sent to pharmacy managers of 127 hospitals of Ministry of Health(MOH); 67.7% responded; data of 63.7% hospitals were valid for analysis. 19 hospitals were chosen deliberately according to their level of development, their data was tested against selected criteria. Due to limitations of data; only 2 criteria were selected:
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
