The perceived and actual use of healthcare resources following intensive care

Abstract

Intensive care is often viewed as expensive and cost benefit analysis has become an essential part of its evaluation. Initially simple mortality statistics were used but now more complex measures such as quality of life1 scores are employed. The complex physical and psychological consequences of an episode of critical illness may influence the patient's quality of life.2 Their use of healthcare resources may reflect their health needs and this has the potential for considerable resource and cost implications.3 This pilot study was performed to investigate the perceived and actual use of healthcare resources by patients following an episode of critical illness. Surviving patients were identified who had spent more than 4 days on the intensive care unit (ICU) and been discharged 6–12 months earlier. The patients were interviewed using a semi-structured format. Questions were asked about their use of healthcare resources since discharge compared with a period before their ICU admission. A perceived quality of life scale was completed and details of the patient's employment status were recorded. At the interview, consent was obtained from the patient to refer to their medical records and note their actual healthcare use. Seventeen patients (10 men) were interviewed, aged 59 (31–77) (median (range)). There was a significant increase in both the perceived and actual use of healthcare resources since discharge from the ICU. This increase was in both the number of different healthcare workers seen (1.82vs 5.18 mean number of healthcare workers/patient; 65% increase;P This pilot study demonstrates that health is an important issue for patients following intensive care. In the 6 months after discharge from the ICU, the majority of patients continue to experience health problems. This is reflected in their increased use of healthcare resources and their reduced quality of life. The provision of healthcare for this group has significant resource and cost implications.