Ebm Claudia, Istrate Melania, Van Gelder Frank, Szőllősi Gergő József, Alexandre Joel, Azoulay Elie, Kesecioglu Jozef, Cecconi Maurizio
Department of Biomedical Sciences, Simulation Center, Humanitas University, Pieve Emanuele, Italy.
European Society of Intensive Care Medicine (ESICM), Brussels, Belgium.
Intensive Care Med. 2025 Aug;51(8):1453-1461. doi: 10.1007/s00134-025-08033-6. Epub 2025 Jul 21.
Although healthcare crises are infrequent, they may place extraordinary stress on Intensive Care Units (ICUs), often exposing critical weaknesses in workforce planning and resulting in acute staffing shortages. This study presents a comprehensive economic evaluation of large-scale, rapid ICU workforce upskilling as a strategic response to such pressures. Specifically, we assess the cost-effectiveness, economic sustainability, and resilience-building potential of these interventions during crisis conditions.
C19_SPACE, a Europe-wide upskilling initiative led by the European Society of Intensive Care Medicine (ESICM), was implemented across 24 countries between 2020 and 2021. A societal economic evaluation and return on investment (ROI) was calculated through deterministic modeling and validated using probabilistic sensitivity analysis across a range of plausible scenarios, including variations in patient throughput, training efficacy, and healthcare system parameters.
The total societal investment in the program was €20.1 million, translating to an average cost of €1146 per participant and €1720 per Quality-Adjusted Healthcare Worker (QAHW). Deterministic modeling estimated an ROI of 478%, with program costs fully recovered in just 5.1 days. Probabilistic sensitivity analysis confirmed the robustness of these findings, with a mean ROI of 455% (95% CI 130-1029%) and a median break-even point of 5.4 days (95% CI 2.66-13.04 days).
Rapid, structured ICU workforce upskilling initiatives deliver substantial economic returns and significantly expands healthcare capacity. Strategic investment in emergency workforce upskilling is economically sound and crucial for healthcare system resilience during future crises.
尽管医疗保健危机并不常见，但它们可能会给重症监护病房（ICU）带来巨大压力，常常暴露出劳动力规划中的关键弱点，并导致严重的人员短缺。本研究对大规模、快速提升ICU工作人员技能作为应对此类压力的战略措施进行了全面的经济评估。具体而言，我们评估了这些干预措施在危机情况下的成本效益、经济可持续性以及恢复力建设潜力。
C19_SPACE是一项由欧洲重症医学学会（ESICM）牵头的全欧洲范围的技能提升倡议，于2020年至2021年在24个国家实施。通过确定性建模计算了社会经济评估和投资回报率（ROI），并在一系列合理情景下使用概率敏感性分析进行了验证，包括患者流量、培训效果和医疗保健系统参数的变化。
该项目的社会总投资为2010万欧元，每位参与者的平均成本为1146欧元，每位质量调整后的医护人员（QAHW）的平均成本为1720欧元。确定性建模估计投资回报率为478%，项目成本仅在5.1天内就完全收回。概率敏感性分析证实了这些结果的稳健性，平均投资回报率为455%（95%可信区间130 - 1029%），盈亏平衡点中位数为5.4天（95%可信区间2.66 - 13.04天）。
快速、结构化的ICU劳动力技能提升举措带来了可观的经济回报，并显著扩大了医疗保健能力。对紧急劳动力技能提升进行战略投资在经济上是合理的，对于未来危机期间医疗保健系统的恢复力至关重要。
