Cost Effectiveness Analysis of Critical Care in Resource Limited Setting

Completed

• Conditions: Critical Illness
• Interventions: Procedure: mechanical ventilation; Procedure: neuromuscular blockade; Procedure: renal replacement therapy; Procedure: non-invasive ventilation

• Registration Number: NCT02556476
• Lead Sponsor: University of Sarajevo

Brief Summary

The purpose of this study was to examine the cost effectiveness of critical care in a middle income country with limited resources.

The main study hypothesis was that critical care is cost effective in low resources setting.

Detailed Description

The investigators objective was to calculate the cost effectiveness of treatment of critically ill patients in a medical ICU of a middle income country with limited access to ICU resources.

Methods: Consecutive critically ill medical patients treated in a recently established medical ICU in Sarajevo, Bosnia and Herzegovina, were prospectively recorded and a subsequent cost utility analysis of intensive care in comparison to hospital ward treatment from the perspective of health care system was performed. Incremental cost effectiveness was calculated using estimates of ICU versus 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.

Study Timeline

• Study Start: 2011-06
• Primary Completion: 2012-06
• Study Completion: 2013-06
• Status Verified: 2015-09
• Study First Submitted: 2015-09-18
• Study First Submitted QC: 2015-09-21
• Last Update Submitted: 2015-09-21
• Study First Posted: 2015-09-22
• Last Update Posted: 2015-09-22

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 148

Inclusion Criteria

• patients treated between June 1 2011 and June 29 2012 in the medical ICU

Exclusion Criteria

• Patients who stayed in the ICU less than 24 hours and
• hospital readmissions

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
ICU patients	neuromuscular blockade	The actual cohort of 148 critically ill medical patients that received the treatment in the intensive care unit (ICU). The interventions include interventions that are usually performed within the ICU such as mechanical ventilation, non-invasive ventilation, neuromuscular blockade, renal replacement therapy.
ICU patients	non-invasive ventilation	The actual cohort of 148 critically ill medical patients that received the treatment in the intensive care unit (ICU). The interventions include interventions that are usually performed within the ICU such as mechanical ventilation, non-invasive ventilation, neuromuscular blockade, renal replacement therapy.
ICU patients	mechanical ventilation	The actual cohort of 148 critically ill medical patients that received the treatment in the intensive care unit (ICU). The interventions include interventions that are usually performed within the ICU such as mechanical ventilation, non-invasive ventilation, neuromuscular blockade, renal replacement therapy.
ICU patients	renal replacement therapy	The actual cohort of 148 critically ill medical patients that received the treatment in the intensive care unit (ICU). The interventions include interventions that are usually performed within the ICU such as mechanical ventilation, non-invasive ventilation, neuromuscular blockade, renal replacement therapy.

Primary Outcome Measures

Name	Time	Method
survival	one year after hospital release	mortality was recorded one year after hospital discharge and subtracted from the value od 100% in order to get one year survival

Secondary Outcome Measures

Name	Time	Method
mortality	30 days and 60 days after critical illness onset and one year after hospital release
health related quality of life (HRQOL)	one year after hospital release	HRQOL was assessed using EQ5D-3L questionnaire