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Health Economic Evaluations in Intensive Care: An Updated Systematic Review
Christina-Le Nguyen1,2,3, Wai Chung Tse1,2,3,4, Thomas M Carney1,2,3
1Monash University, School of Public Health and Preventive Medicine, Melbourne, VIC, Australia.
Critical Care Explorations
|July 17, 2025
Summary
Health economic evaluations in intensive care are scarce and highly varied. Future research should focus on low- and middle-income countries and trial-based studies to improve healthcare decision-making.
Area of Science:
- Health Economics
- Critical Care Medicine
Background:
- Intensive care is vital but resource-intensive.
- Health economic evaluations (HE) like cost-effectiveness analyses (CEAs) inform healthcare decisions.
- Understanding the economic landscape of intensive care is crucial for resource allocation.
Purpose of the Study:
- To systematically identify and summarize existing health economic evaluations in intensive care.
- To identify gaps and areas for future research in this field.
Main Methods:
- Searched six academic databases (Ovid, EBSCO, Web of Science) for HE studies of adult ICU interventions published 1993-2023.
- Included CEAs, cost-utility, cost-benefit, and cost-minimization analyses.
- Excluded pediatric, animal, and weaning center studies.
Main Results:
- Identified 219 studies, with a notable increase in recent years.
- Most studies (97%) demonstrated good to excellent reporting quality.
- Incremental cost-effectiveness ratios (ICERs) showed wide variation, from dominant to over $750,000 per life saved.
Conclusions:
- Cost-effectiveness studies in intensive care are relatively scarce compared to other medical fields.
- Significant heterogeneity exists in economic evaluations within intensive care.
- Recommended future research in low- and middle-income countries (LMICs) and increased trial-based studies.
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