Costs of Australian intensive care: A systematic review
Date
2024
Authors
Carrandi, A.
Liew, C.
Maiden, M.J.
Litton, E.
Taylor, C.
Thompson, K.
Higgins, A.
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Journal article
Citation
Critical Care and Resuscitation, 2024; 26(2):153-158
Statement of Responsibility
Alayna Carrandi, Cheelim Liew, Matthew J. Maiden, Edward Litton, Colman Taylor, Kelly Thompson, Alisa Higgins
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Abstract
Objective Intensive care unit (ICU) cost estimates are critical to achieving healthcare system efficiency and sustainability. We aimed to review the published literature describing ICU costs in Australia. Design A systematic review was conducted to identify studies that estimated the cost of ICU care in Australia. Studies conducted in specific patient cohorts or on specific treatments were excluded. Data sources Relevant studies were sourced from a previously published review (1970–2016), a systematic search of MEDLINE and EMBASE (2016–5 May 2023), and reference checking. Review methods A tool was developed to assess study quality and risk of bias (maximum score 57/57). Total and component costs were tabulated and indexed to 2022 Australian Dollars. Costing methodologies and study quality assessments were summarised. Results Six costing studies met the inclusion criteria. Study quality scores were low (15/41 to 35/47). Most studies were conducted only in tertiary metropolitan public ICUs; sample sizes ranged from 100 to 10,204 patients. One study used data collected within the past 10 years. Mean daily ICU costs ranged from $966 to $5381 and mean total ICU admission costs $4888 to $14,606. Three studies used a top-down costing approach, deriving cost estimates from budget reports. The other three studies used both bottom-up and top-down costing approaches. Bottom-up approaches collected individual patient resource use. Conclusions Available ICU cost estimates are largely outdated and lack granular data. Future research is needed to estimate ICU costs that better reflect current practice and patient complexity and to determine the best methods for generating these estimates.
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© 2024 The Authors. Published by Elsevier B.V. on behalf of College of Intensive Care Medicine of Australia and New Zealand. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).