Skip to main content
Top
Published in: BMC Emergency Medicine 1/2019

Open Access 01-12-2019 | Intoxication | Research article

The healthcare costs of intoxicated patients who survive ICU admission are higher than non-intoxicated ICU patients: a retrospective study combining healthcare insurance data and data from a Dutch national quality registry

Authors: Ilse van Beusekom, Ferishta Bakhshi-Raiez, Nicolette F. de Keizer, Dylan W. de Lange

Published in: BMC Emergency Medicine | Issue 1/2019

Login to get access

Abstract

Background

The aim of this study was to describe the healthcare costs of intoxicated ICU patients in the year before and the year after ICU admission, and to compare their healthcare costs with non-intoxicated ICU patients and a population based control group.

Methods

We conducted a retrospective cohort study, combining a national health insurance claims database and a national quality registry database for ICUs. Claims data in the timeframe 2012 until 2014 were combined with the clinical data of patients who had been admitted to an ICU during 2013. Three study populations were compared and matched according to socioeconomic status, type of admission, age and gender: an “ICU population”, an “intoxication population” and a “control population” (who had never been on the ICU).

Results

2591 individual “intoxicated ICU patients” were compared to 2577 general “ICU patients” and 2591 patients from the “control population”. The median and interquartile ranges (IQR) healthcare costs per day alive for the “intoxicated ICU patients” were higher during the year before ICU admission (€20.3 (IQR €3.6–€76.4)) and the year after ICU admission (€23.9 (IQR €5.1–€82.4)) compared to the ICU population (€6.1 (IQR €0.9–€29.3) and €13.6 (IQR €3.3–€54.9) respectively) and a general control population (€1.1 (IQR €0.3–€4.6) and €1.1 (IQR €0.4–€4.9) respectively). The healthcare associated costs in intoxicated ICU patients were correlated with the number of chronic conditions present prior ICU admission (p < 0.0001).

Conclusions

Intoxicated patients admitted to the ICU had in the year before and after ICU admission much higher median healthcare costs per day alive compared to other ICU patients and a general population control group. Healthcare costs are greatly influenced by the number of psychiatric and other chronic conditions of these intoxicated patients.
Appendix
Available only for authorised users
Literature
1.
go back to reference Koster-Brouwer ME, van de Groep K, Pasma W, et al. Chronic healthcare expenditure in survivors of sepsis in the intensive care unit. Intensive Care Med. 2016;42(10):1641–2.PubMedCrossRef Koster-Brouwer ME, van de Groep K, Pasma W, et al. Chronic healthcare expenditure in survivors of sepsis in the intensive care unit. Intensive Care Med. 2016;42(10):1641–2.PubMedCrossRef
2.
go back to reference van Beusekom I, Bakhshi-Raiez F, de Keizer NF, et al. Healthcare cost of ICU survivors are higher before and after ICU admission compared to a population based control group: a descriptive study combining healthcare insurance data and data from a Dutch national quality registry. J Crit Care. 2017;44:345–51.PubMedCrossRef van Beusekom I, Bakhshi-Raiez F, de Keizer NF, et al. Healthcare cost of ICU survivors are higher before and after ICU admission compared to a population based control group: a descriptive study combining healthcare insurance data and data from a Dutch national quality registry. J Crit Care. 2017;44:345–51.PubMedCrossRef
3.
go back to reference Lam SM, Lau AC, Yan WW. Over 8 years experience on severe acute poisoning requiring intensive care in Hong Kong, China. Hum Exp Toxicol. 2010;29(9):757–65.PubMedCrossRef Lam SM, Lau AC, Yan WW. Over 8 years experience on severe acute poisoning requiring intensive care in Hong Kong, China. Hum Exp Toxicol. 2010;29(9):757–65.PubMedCrossRef
4.
go back to reference Henderson A, Wright M, Pond SM. Experience with 732 acute overdose patients admitted to an intensive care unit over six years. Med J Aust. 1993;158(1):28–30.PubMed Henderson A, Wright M, Pond SM. Experience with 732 acute overdose patients admitted to an intensive care unit over six years. Med J Aust. 1993;158(1):28–30.PubMed
5.
go back to reference Brandenburg R, Brinkman S, de Keizer NF, et al. In-hospital mortality and long-term survival of patients with acute intoxication admitted to the ICU. Crit Care Med. 2014;42(6):1471–9.PubMedCrossRef Brandenburg R, Brinkman S, de Keizer NF, et al. In-hospital mortality and long-term survival of patients with acute intoxication admitted to the ICU. Crit Care Med. 2014;42(6):1471–9.PubMedCrossRef
6.
go back to reference Green SL, Dargan DI, Jones AL. Acute poisoning: understanding 90% of cases in a nutshell. Postgrad Med J. 2005;81:204–16.CrossRef Green SL, Dargan DI, Jones AL. Acute poisoning: understanding 90% of cases in a nutshell. Postgrad Med J. 2005;81:204–16.CrossRef
7.
go back to reference NVIC Jaaroverzicht 2017. Acute vergiftigingen bij mens en dier. NVIC Rapport 07/2018, Nationaal Vergiftigingen Informatie Centrum, Universitair Medisch Centrum Utrecht, 2018. [Acute poisonings in humans and animals Rapport 07/2018]. Available through http://www.umcutrecht.nl/nvic. Last Accessed 29 Nov 2018. NVIC Jaaroverzicht 2017. Acute vergiftigingen bij mens en dier. NVIC Rapport 07/2018, Nationaal Vergiftigingen Informatie Centrum, Universitair Medisch Centrum Utrecht, 2018. [Acute poisonings in humans and animals Rapport 07/2018]. Available through http://​www.​umcutrecht.​nl/​nvic. Last Accessed 29 Nov 2018.
8.
go back to reference Halpern NA, Pastores SM. Critical care medicine in the United States 2000-2005: an analysis of bed numbers, occupancy rates, payer mix, and costs. Crit Care Med. 2010;38:65–71.PubMedCrossRef Halpern NA, Pastores SM. Critical care medicine in the United States 2000-2005: an analysis of bed numbers, occupancy rates, payer mix, and costs. Crit Care Med. 2010;38:65–71.PubMedCrossRef
9.
go back to reference Lefrant JY, Garrigues B, Pribil C, et al. The daily cost of ICU patients: a micro-costing study in 23 French intensive care units. Anaesth Crit Care Pain Med. 2015;34(3):151–7.PubMedCrossRef Lefrant JY, Garrigues B, Pribil C, et al. The daily cost of ICU patients: a micro-costing study in 23 French intensive care units. Anaesth Crit Care Pain Med. 2015;34(3):151–7.PubMedCrossRef
10.
go back to reference Böll R, Romanek K, Schmoll S, et al. Independent validation of the ICU requirement score in a cohort of acutely poisoned adults. Clin Toxicol. 2017;16:1–3. Böll R, Romanek K, Schmoll S, et al. Independent validation of the ICU requirement score in a cohort of acutely poisoned adults. Clin Toxicol. 2017;16:1–3.
11.
12.
go back to reference Zimmerman JE, Kramer AA, McNair DS, et al. Acute physiology and chronic health evaluation (APACHE) IV: hospital mortality assessment for today's critically ill patients. Crit Care Med. 2006;34(5):1297–310.PubMedCrossRef Zimmerman JE, Kramer AA, McNair DS, et al. Acute physiology and chronic health evaluation (APACHE) IV: hospital mortality assessment for today's critically ill patients. Crit Care Med. 2006;34(5):1297–310.PubMedCrossRef
15.
go back to reference Roos LL, Wajda A. Record linkage strategies. Part I: estimating information and evaluating approaches. Methods Inf Med. 1991 Apr;30(2):117–23.PubMedCrossRef Roos LL, Wajda A. Record linkage strategies. Part I: estimating information and evaluating approaches. Methods Inf Med. 1991 Apr;30(2):117–23.PubMedCrossRef
16.
go back to reference Tanuseputro P, Wodchis WP, Fowler R, et al. The healthcare cost of dying: a population-based retrospective cohort study of the last year of life in Ontario, Canada. PLoS One. 2015;10(3):e0121759.PubMedPubMedCentralCrossRef Tanuseputro P, Wodchis WP, Fowler R, et al. The healthcare cost of dying: a population-based retrospective cohort study of the last year of life in Ontario, Canada. PLoS One. 2015;10(3):e0121759.PubMedPubMedCentralCrossRef
17.
go back to reference Sut N, Memis D. Intensive care costs of acute poisoning cases. Clin Toxicol (Phila). 2008;46(5):457–60.CrossRef Sut N, Memis D. Intensive care costs of acute poisoning cases. Clin Toxicol (Phila). 2008;46(5):457–60.CrossRef
18.
go back to reference Ramchandani P, Murray B, Hawton K, et al. Deliberate self poisoning with antidepressant drugs: a comparison of the relative hospital costs of cases of overdose of tricyclics with those of selective-serotonin re-uptake inhibitors. J Affect Disord. 2000;60(2):97–100.PubMedCrossRef Ramchandani P, Murray B, Hawton K, et al. Deliberate self poisoning with antidepressant drugs: a comparison of the relative hospital costs of cases of overdose of tricyclics with those of selective-serotonin re-uptake inhibitors. J Affect Disord. 2000;60(2):97–100.PubMedCrossRef
19.
go back to reference Serinken M, Karcioglu O, Sengul C, et al. Hospital costs of managing deliberate self-poisoning in Turkey. Med Sci Monit. 2008;14(3):CR152–8.PubMed Serinken M, Karcioglu O, Sengul C, et al. Hospital costs of managing deliberate self-poisoning in Turkey. Med Sci Monit. 2008;14(3):CR152–8.PubMed
20.
go back to reference Kapur N, House A, Creed F, et al. General hospital services for deliberate self-poisoning: an expensive road to nowhere? Postgrad Med J. 1999;75(888):599–602.PubMedPubMedCentralCrossRef Kapur N, House A, Creed F, et al. General hospital services for deliberate self-poisoning: an expensive road to nowhere? Postgrad Med J. 1999;75(888):599–602.PubMedPubMedCentralCrossRef
21.
go back to reference Shahid M, Khan MM, Naqvi H, et al. Cost of treatment of deliberate self-harm. A study from Pakistan. Crisis. 2008;29(4):213–5.PubMedCrossRef Shahid M, Khan MM, Naqvi H, et al. Cost of treatment of deliberate self-harm. A study from Pakistan. Crisis. 2008;29(4):213–5.PubMedCrossRef
22.
go back to reference D'Mello DA, Finkbeiner DS, Kocher KN. The cost of antidepressant overdose. Gen Hosp Psychiatry. 1995;17(6):454–5.PubMedCrossRef D'Mello DA, Finkbeiner DS, Kocher KN. The cost of antidepressant overdose. Gen Hosp Psychiatry. 1995;17(6):454–5.PubMedCrossRef
24.
go back to reference Kavalci G, Ethemoglu FB, Batuman A, et al. Epidemiological and cost analysis of self-poisoning cases in Ankara, Turkey. Iran Red Crescent Med J. 2014;16(11):e10856.PubMedPubMedCentralCrossRef Kavalci G, Ethemoglu FB, Batuman A, et al. Epidemiological and cost analysis of self-poisoning cases in Ankara, Turkey. Iran Red Crescent Med J. 2014;16(11):e10856.PubMedPubMedCentralCrossRef
25.
go back to reference McMahon A, Brohan J, Donnelly M, et al. Characteristics of patients admitted to the intensive care unit following self-poisoning and their impact on resource utilisation. Ir J Med Sci. 2014;183(3):391–5.PubMedCrossRef McMahon A, Brohan J, Donnelly M, et al. Characteristics of patients admitted to the intensive care unit following self-poisoning and their impact on resource utilisation. Ir J Med Sci. 2014;183(3):391–5.PubMedCrossRef
26.
go back to reference Kittelsen SS, Barber JA, Harrington R. Factors that influence the cost of deliberate self-poisoning in children and adolescents. J Ment Health Policy Econ. 2001;4(3):113–21.PubMed Kittelsen SS, Barber JA, Harrington R. Factors that influence the cost of deliberate self-poisoning in children and adolescents. J Ment Health Policy Econ. 2001;4(3):113–21.PubMed
27.
go back to reference Okumura Y, Sakata N, Takahashi K, et al. Epidemiology of overdose episodes from the period prior to hospitalization for drug poisoning until discharge in Japan: an exploratory descriptive study using a nationwide claims database. J Epidemiol. 2017;27(8):373–80.PubMedPubMedCentralCrossRef Okumura Y, Sakata N, Takahashi K, et al. Epidemiology of overdose episodes from the period prior to hospitalization for drug poisoning until discharge in Japan: an exploratory descriptive study using a nationwide claims database. J Epidemiol. 2017;27(8):373–80.PubMedPubMedCentralCrossRef
28.
go back to reference Sznajder M, Aegerter P, Launois R, et al. A cost-effectiveness analysis of stays in intensive care units. Intensive Care Med. 2001;27(1):146–53.PubMedCrossRef Sznajder M, Aegerter P, Launois R, et al. A cost-effectiveness analysis of stays in intensive care units. Intensive Care Med. 2001;27(1):146–53.PubMedCrossRef
29.
go back to reference Brandenburg R, Soliman IW, Meulenbelt J, et al. Raising awareness for a low health-related quality of life in intoxicated ICU patients. Clin Toxicol (Phila). 2015;53(6):585.CrossRef Brandenburg R, Soliman IW, Meulenbelt J, et al. Raising awareness for a low health-related quality of life in intoxicated ICU patients. Clin Toxicol (Phila). 2015;53(6):585.CrossRef
30.
go back to reference Lone NI, Gillies MA, Haddow C, et al. Five-year mortality and hospital costs associated with surviving intensive care. Am J Respir Crit Care Med. 2016;194(2):198–208.PubMedPubMedCentralCrossRef Lone NI, Gillies MA, Haddow C, et al. Five-year mortality and hospital costs associated with surviving intensive care. Am J Respir Crit Care Med. 2016;194(2):198–208.PubMedPubMedCentralCrossRef
Metadata
Title
The healthcare costs of intoxicated patients who survive ICU admission are higher than non-intoxicated ICU patients: a retrospective study combining healthcare insurance data and data from a Dutch national quality registry
Authors
Ilse van Beusekom
Ferishta Bakhshi-Raiez
Nicolette F. de Keizer
Dylan W. de Lange
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Intoxication
Published in
BMC Emergency Medicine / Issue 1/2019
Electronic ISSN: 1471-227X
DOI
https://doi.org/10.1186/s12873-019-0224-7

Other articles of this Issue 1/2019

BMC Emergency Medicine 1/2019 Go to the issue