Characteristics and outcome of high-cost ICU patients

Yin Nwe Aung, Amrizal M. Nur, Aniza Ismail, Syed M. Aljunid

Research output: Contribution to journalArticle

Abstract

Purpose: Care at ICUs is expensive and variable depending on the type of care that the patients received. Knowing the characteristics of the patient and his or her disease is always useful for improving health services and cost containment. Patients and methods: An observational study was conducted at four different intensive care units of an academic medical institution. Demographic characteristics, disease-manage-ment casemix information, cost and outcome of the high costing decile, and the rest of the cases were compared. Results: A total of 3,220 discharges were included in the study. The high-cost group contributed 35.4% of the ICU stays and 38.8% of the total ICU expenditure. Diseases of the central nervous system had higher odds to be in the top decile of costly patients whereas the cardiovascular system was more likely to be in the non-high cost category. The high-cost patients were more likely to have death as an outcome (19.2% vs 9.3%; p<0.001). The most common conditions that were in the high-cost groups were craniotomy, other ear, nose, mouth, and throat operations, simple respiratory system operations, complex intestinal operations, and septicemia. These five diagnostic groups made up 43% of the high-cost decile. Conclusion: High-cost patients utilized almost 40% of the ICU cost although they were only 10% of the ICU patients. The chances of admission to the ICU increased with older age and severity level of the disease. Central nervous system diseases were the major problem of patients aged 46–69 years old. In addition to cost reduction strategies at the treatment level, detailed analysis of these cases was needed to explore and identify pre-event stage prevention strategies.

Original languageEnglish
Pages (from-to)505-513
Number of pages9
JournalClinicoEconomics and Outcomes Research
Volume11
DOIs
Publication statusPublished - 1 Jan 2019

Fingerprint

Costs and Cost Analysis
Central Nervous System Diseases
Costs
Cost Control
Craniotomy
Health Expenditures
Cardiovascular System
Pharynx
Nose
Health Care Costs
Respiratory System
Health Services
Observational Studies
Ear
Intensive Care Units
Mouth
Sepsis
Patient Care
Demography

Keywords

  • Burden
  • Casemix
  • Health services
  • Malaysia
  • MY-DRG
  • Utilization

ASJC Scopus subject areas

  • Economics, Econometrics and Finance (miscellaneous)
  • Health Policy

Cite this

Characteristics and outcome of high-cost ICU patients. / Aung, Yin Nwe; Nur, Amrizal M.; Ismail, Aniza; Aljunid, Syed M.

In: ClinicoEconomics and Outcomes Research, Vol. 11, 01.01.2019, p. 505-513.

Research output: Contribution to journalArticle

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