A cost-benefit analysis of intensive therapy

The daily costs of 90 critically ill patients treated on an intensive therapy unit were calculated on an individual patient basis. Twenty-one patients (23%) died on the intensive therapy unit and another 13 (15%) died within one year of discharge. The results demonstrate that there is wide variation in costs among the patients and the diagnoses. The mean daily cost of nonsurvivors was almost 300 pounds greater than that of survivors (816 pounds (95% confidence interval = 649-982 pounds) versus 550 pounds (498-601 pounds). Renal failure, sepsis and pneumonia proved to be some of the most expensive conditions to treat, and postoperative respiratory failure the cheapest. The cost of the first day of management was significantly related to the APACHE II score and individual costs on the first day may be predicted from admission APACHE II score. Patients who die in the intensive therapy unit continue to incur the same level of expenditure throughout admission. The study could not provide conclusive answers concerning the trend in daily costs for survivors.