Determining the costs of intensive care

Accurately determining the costs of intensive care is challenging. The increasing demand for intensive care, coupled with newer, more expensive technologies, means it is essential that we understand the costs of providing care. Economic evaluations of new (or existing) therapies are essential in intensive care, however accurate costs are required to enable economic evaluations to be performed. Currently, the majority of economic evaluations of IUC therapies in Australia use per diem costs for ICU, with the same daily cost applied regardless of the level of care (for example, the number of organ supports) being provided to the patient. This project will involve developing a greater understanding of the costs of intensive care services in Australia. It will involve data linkage of high quality datasets, including the the ANZICS Centre for Outcome and Resource Evaluation (CORE) Adult Patient Database (APD) (an ICU registry that contains data from over 2 million patient episodes and is one of the largest single datasets on intensive care in the world), the Admitted Episodes Dataset and the Emergency Minimum Datasets in each State and Territory (for example, the Victorian Admitted Episodes Dataset and the Victorian Emergency Minimum Dataset), and Cost Data Collections, where available. The ANZICS CORE APD contains detailed patient-level information on admission diagnoses, illness severity scores, physiological and laboratory results, and therapies received during the ICU admission. However, it contains only limited pre-admission data points and does not contain any post-hospital discharge data. Such data is available in the Admitted Episodes Dataset and the Emergency Minimum Datasets in each State and Territory, which contain data on all admitted patients from public and private hospitals including rehabilitation centres, extended care facilities and day procedure centres. The Cost Data Collections are datasets reflecting the cost and mix of resources used to deliver patient care and determines the total cost for each public hospital admission. The linkage of these datasets will provide an opportunity for population level data which contains significant information about the ICU admission, enabling a level of granularity that has not been available in any previous studies conducted internationally.