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AIM:To calculate cost effectiveness of the treatment of critically ill patients in a medical intensive care unit(ICU)of a middle income country with limited access to ICU resources.METHODS:A prospective cohort study and economic evaluation of consecutive patients treated in a recently established medical ICU in Sarajevo,Bosnia and Herzegovina.A cost utility analysis of the intensive care of critically ill patients compared to the hospital ward treatment from the perspective of the health care system was subsequently performed.Incremental cost effectiveness was calculated using estimates of ICU vs non-ICU treatment effectiveness based on a formal systematic review of published studies.Decision analytic modeling was used to compare treatment alternatives.Sensitivity analyses of the key model parameters were performed.RESULTS:Out of 148 patients,seventy patients(47.2%)survived to one year after critical illness with a median quality of life index 0.64[interquartile range(IQR)0.49-0.76].Median number of life years gained per patient was 30(IQR 16-40)or 18 quality adjusted life years(QALYs)(IQR 7-28).The cost of treatment of critically ill patients varied between 1820 dollar and 20109 dollar per hospital survivor and between 100 dollar and 2514 dollar per QALY saved.Mean factors that influenced costs were:Age,diagnostic category,ICU and hospital length of stay and number and type of diagnostic and therapeutic interventions.The incremental cost effectiveness ratio for ICU treatment was estimated at 3254 dollar per QALY corresponding to 35%of per capita GDP or a Very Cost Effective category according to World Health Organization criteria.CONCLUSION:The ICU treatment of critically ill medical patients in a resource poor country is cost effective and compares favorably with other medical interventions.Public health authorities in low and middle income countries should encourage development of critical care services.
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篇名 Cost effectiveness of intensive care in a low resource setting:A prospective cohort of medical critically ill patients
来源期刊 世界重症医学杂志 学科 医学
关键词 Cost BENEFIT ANALYSIS INTENSIVE CARE Quality of life INTENSIVE CARE unit MORTALITY Decision ANALYSIS ECONOMICS
年,卷(期) 2016,(2) 所属期刊栏目
研究方向 页码范围 150-164
页数 15页 分类号 R
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Cost
BENEFIT
ANALYSIS
INTENSIVE
CARE
Quality
of
life
INTENSIVE
CARE
unit
MORTALITY
Decision
ANALYSIS
ECONOMICS
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研究来源
研究分支
研究去脉
引文网络交叉学科
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期刊影响力
世界重症医学杂志
不定期
2220-3141
北京市朝阳区东四环中路62号楼远洋国际中
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156
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0
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