The Effect of Different Patient Population on Clinical Outcome and Intensive Care Costs
Pařízková R., Černý V., Dostál P.
Klinika anesteziologie, resuscitace a intenzivní medicíny, LF UK a FN, Hradec Králové, přednosta doc. MUDr. Vladimír Černý, PhD., FCCM |
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Summary:
Financial burden associated with intensive care represent an important part of used financial resources of health care systems in developed countries.
The efforts of effective allocation of financial resources should be an integral part of all scientific decision making process in daily clinical routine.
The aim of the study was to evaluate the most frequent patient populations seen as the diagnosis related groups with respect to the clinical outcome
and to the financial costs associated with the health care provided. The patient population was divided into four basic groups: sepsis and its
complications (SE, n = 99), polytrauma (TR, n = 109), head injury (KCP, n = 86) and post-CPR states (KPR, n = 74). APACHE II and SOFA scores
were statistically significantly higher in non-survivors compared to survivors; the length of stay was statistically significantly longer in survivors. The
highest mortality rate could be observed in post-CPR patients (48,6%), the least mortality in polytrauma patients (12,8%). The mean financial cost
per patient of the group was 211,520 ± 257,889 CZK (877–2.126,000), median 126,092 (25% percentile 37,322; 75% percentile 311,330).
Non-survivors of the group shown statistically significantly lower financial costs of in-hospital stay compared to survivors, mean 174,330 ± 304,230,
resp. 223,049 ± 241,145 (median 53,608; 25% percentile 18,981; 75% percentile 190,800; resp. 151,404; 50,428; 325,054). The key factor most
affecting the financial costs of all patients was the length of stay.
Key words:
intensive care – APACHE II – SOFA – costs
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