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Review of A Large Clinical Series: A Microcosting Study of Intensive Care Unit Stay in the Netherlands

Erasmus MC University Medical Center, Institute for Medical Technology Assessment, Rotterdam, s.s.tan{at}erasmusmc.nl

Leona Hakkaart-van Roijen, PhD

Erasmus MC University Medical Center, Institute for Medical Technology Assessment, Rotterdam

Maiwenn J. Al, PhD

Erasmus MC University Medical Center, Institute for Medical Technology Assessment, Rotterdam

Clazien A. Bouwmans, MSc

Erasmus MC University Medical Center, Institute for Medical Technology Assessment, Rotterdam

Marga E. Hoogendoorn, MSc

Department of Intensive Care, Isala Clinics, Zwolle

Peter E. Spronk, PhD

Department of Intensive Care Medicine, Gelre Hospital (Lukas site), Apeldoorn

Jan Bakker, PhD

Department of Intensive Care, Erasmus MC University Medical Center, Rotterdam, Netherlands

The primary objective of this study was to estimate the actual daily costs of intensive care unit stay using a microcosting methodology. As a secondary objective, the degree of association between daily intensive care unit costs and some patient characteristics was examined. This multicenter, retrospective cost analysis was conducted in the medical-surgical adult intensive care units of 1 university and 2 general hospitals in the Netherlands for 2006, from a hospital perspective. A total of 576 adult patients were included, consuming a total of 2868 nursing days. The mean total costs per intensive care unit day were 1911, with labour (33%) and indirect costs (33%) as the most important cost drivers. An ordinary least squares analysis including age, Nine Equivalent of Nursing Manpower Use score/Therapeutic Intervention Scoring System score, mechanical ventilation, blood products, and renal replacement therapy was able to predict 50% of the daily intensive care unit costs.

Key Words: intensive care • microcosting • cost analysis • ICU stay • mechanical ventilation

This version was published on July 1, 2008

Journal of Intensive Care Medicine, Vol. 23, No. 4, 250-257 (2008)
DOI: 10.1177/0885066608318661


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