Abstract
BackgroundThe aim of this study was to describe the healthcare costs of intoxicated ICU patients in the year before and the year after ICU admission, and to compare their healthcare costs with non-intoxicated ICU patients and a population based control group.MethodsWe conducted a retrospective cohort study, combining a national health insurance claims database and a national quality registry database for ICUs. Claims data in the timeframe 2012 until 2014 were combined with the clinical data of patients who had been admitted to an ICU during 2013. Three study populations were compared and matched according to socioeconomic status, type of admission, age and gender: an “ICU population”, an “intoxication population” and a “control population” (who had never been on the ICU).Results2591 individual “intoxicated ICU patients” were compared to 2577 general “ICU patients” and 2591 patients from the “control population”. The median and interquartile ranges (IQR) healthcare costs per day alive for the “intoxicated ICU patients” were higher during the year before ICU admission (€20.3 (IQR €3.6–€76.4)) and the year after ICU admission (€23.9 (IQR €5.1–€82.4)) compared to the ICU population (€6.1 (IQR €0.9–€29.3) and €13.6 (IQR €3.3–€54.9) respectively) and a general control population (€1.1 (IQR €0.3–€4.6) and €1.1 (IQR €0.4–€4.9) respectively). The healthcare associated costs in intoxicated ICU patients were correlated with the number of chronic conditions present prior ICU admission (p < 0.0001).ConclusionsIntoxicated patients admitted to the ICU had in the year before and after ICU admission much higher median healthcare costs per day alive compared to other ICU patients and a general population control group. Healthcare costs are greatly influenced by the number of psychiatric and other chronic conditions of these intoxicated patients.
Highlights
The aim of this study was to describe the healthcare costs of intoxicated Intensive care Unit (ICU) patients in the year before and the year after ICU admission, and to compare their healthcare costs with non-intoxicated ICU patients and a population based control group
Previous studies on the costs of intoxicated patients admitted to the ICU only focused on direct ICU-associated or hospital-associated expenditures [17,18,19,20,21,22,23,24,25]
We showed that intoxicated people who were admitted to an ICU had higher healthcare costs per day alive compared to an other ICU population and a control population
Summary
The aim of this study was to describe the healthcare costs of intoxicated ICU patients in the year before and the year after ICU admission, and to compare their healthcare costs with non-intoxicated ICU patients and a population based control group. More severe intoxications (both accidental or intentional) in adults are treated in the emergency department and many of those patients are admitted to the hospital (or even to the Intensive Care Unit (ICU) [8, 9]. Many of the intoxicated ICU patients have a short length of stay on the ICU and the hospital and long-term mortality are relatively low [10]. This suggests that cost/effectiveness ratio, which is defined by the cost of treatment divided by the expected years alive, is supposedly very good for intoxicated patients. Long-term sequelae are often ignored in these analyses
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