Economics and the intensive care unit: a conflict of interests?

Economic evaluation in critical care: a focus on severe sepsis in oncology

Hospital care, physician and clinical services, and prescription drugs continue to drive healthcare expenditures across healthcare systems and nations. The critical-care setting, owing to the complexity and intensity of care, is a high user of the resources that drive healthcare spending. Information regarding the cost and effectiveness of critical-care therapies is necessary to properly guide care and policies for this unique population. Many challenges exist for conducting and comparing economic evaluation in critical care. Recently, recommendations on cost and cost-effectiveness analysis in critical care have been developed that will guide future research. A focus area, severe sepsis in oncology, is reviewed to highlight the challenges and opportunities of economic evaluation in this setting.

Economic stress and misaligned incentives in critical care medicine in the United States

OBJECTIVES

This review will provide an overview of issues with economic ramifications intrinsic to the management of intensive care resources and identify some of the external pressures that ultimately influence the provision of intensive care services.

DESIGN

A review of the current literature was performed.

RESULTS

Economic stress is a reality of the management of intensive care resources. The nature of critical care medicine as a technologically heavy, labor intensive, high-cost, limited resource, combined with a projected increase in demand in an era of cost containment, presents an array of challenges.

CONCLUSIONS

It is in the best interest of the care of our patients that critical care providers increase awareness of the many factors influencing our practice economically. It is through such understanding that challenges can be met, solutions can be found, and the quality of intensive care can be improved in a financially sustainable environment.