Comparative costing analysis of intensive care services between Hungary and United Kingdom

The study presents the findings of the first National Intensive Care Cost Block Analysis in Hungary.

There were 13 Intensive Care Units (ICUs) involved in this study: 5 University Hospitals, 6 District County Hospitals and 2 City Hospitals. The annual costs of ICUs were measured by "top-down" approach based on Cost Block Method. Annual expenditure of 3 cost blocks was collected for year 2000: clinical support, consumables and staff costs. On top of the annual costs, we collected general ICU data and Top 10 drugs of each unit. Our data was compared to National Cost Block data of United Kingdom.

There were 9313 patients involved in the study. The median (IQR) ICU occupancy rate was 67% (62-79), mortality was 21% (11-26). The mean cost per bed was 30,990 Euro (SD 12,573) and 144 Euro (SD 63,1) per patient day. Clinical support services were accounted for 9.6% of resources, consumables for 60.6% and staff costs for 29.8%.

Intensive care costs are very low in Hungary compared to other European countries. The difference is explained by the cheaper staff cost, but the lower number of nurses per ICU bed contributes as well.