Carrandi Alayna, Liew Cheelim, Maiden Matthew J, Litton Edward, Taylor Colman, Thompson Kelly, Higgins Alisa
Australian and New Zealand Clinical Trials Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Eastern Health, Box Hill Hospital, Department of Intensive Care Services, Box Hill, Victoria, Australia.
Crit Care Resusc. 2024 Jun 21;26(2):153-158. doi: 10.1016/j.ccrj.2024.03.003. eCollection 2024 Jun.
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.
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.
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.
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.
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.
Available ICU cost estimates are largely outdated and lack granular data.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.
重症监护病房（ICU）成本估算对于实现医疗系统的效率和可持续性至关重要。我们旨在回顾已发表的描述澳大利亚ICU成本的文献。
进行了一项系统综述，以识别估算澳大利亚ICU护理成本的研究。排除在特定患者队列或特定治疗上进行的研究。
相关研究来自先前发表的综述（1970 - 2016年）、对MEDLINE和EMBASE的系统检索（2016年 - 2023年5月5日）以及参考文献核对。
开发了一种工具来评估研究质量和偏倚风险（最高分数57/57）。将总成本和分项成本制成表格，并换算为2022澳元。总结了成本核算方法和研究质量评估。
六项成本核算研究符合纳入标准。研究质量得分较低（15/41至35/47）。大多数研究仅在大都市三级公立ICU进行；样本量从100至10204名患者不等。一项研究使用了过去10年内收集的数据。ICU每日平均成本从966澳元至5381澳元不等，ICU入院总平均成本为4888澳元至14606澳元。三项研究采用自上而下的成本核算方法，从预算报告中得出成本估算。其他三项研究同时使用了自下而上和自上而下的成本核算方法。自下而上的方法收集了个体患者的资源使用情况。
现有的ICU成本估算大多过时且缺乏详细数据。需要未来的研究来估算能更好反映当前实践和患者复杂性的ICU成本，并确定生成这些估算的最佳方法。
