Cost Effectiveness Analysis of Critical Care in Resource Limited Setting

NCT ID: NCT02556476

Last Updated: 2015-09-22

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 148 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2011-06-30
• Study Completion Date: 2013-06-30

Brief Summary

The purpose of this study was to examine the cost effectiveness of critical care in a middle income country with limited resources.

The main study hypothesis was that critical care is cost effective in low resources setting.

Detailed Description

The investigators objective was to calculate the cost effectiveness of treatment of critically ill patients in a medical ICU of a middle income country with limited access to ICU resources.

Methods: Consecutive critically ill medical patients treated in a recently established medical ICU in Sarajevo, Bosnia and Herzegovina, were prospectively recorded and a subsequent cost utility analysis of intensive care in comparison to hospital ward treatment from the perspective of health care system was performed. Incremental cost effectiveness was calculated using estimates of ICU versus non-ICU treatment effectiveness based on a formal systematic review of published studies. Decision analytic modeling was used to compare treatment alternatives. Sensitivity analyses of the key model parameters were performed.

Conditions

Critical Illness

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

ICU patients

The actual cohort of 148 critically ill medical patients that received the treatment in the intensive care unit (ICU). The interventions include interventions that are usually performed within the ICU such as mechanical ventilation, non-invasive ventilation, neuromuscular blockade, renal replacement therapy.

mechanical ventilation

Intervention Type: PROCEDURE

ventilator support for the patients presenting with acute respiratory failure

neuromuscular blockade

Intervention Type: PROCEDURE

paralysis of the skeletal muscles in order to optimize mechanical ventilation, especially during ARDS

renal replacement therapy

Intervention Type: PROCEDURE

the procedures used to treat acute kidney injury

non-invasive ventilation

Intervention Type: PROCEDURE

Procedure used for ventilation support in patients with congestive heart failure, pulmonary edema, COPD and some other conditions.

Interventions

mechanical ventilation

ventilator support for the patients presenting with acute respiratory failure

Intervention Type: PROCEDURE

neuromuscular blockade

paralysis of the skeletal muscles in order to optimize mechanical ventilation, especially during ARDS

Intervention Type: PROCEDURE

renal replacement therapy

the procedures used to treat acute kidney injury

Intervention Type: PROCEDURE

non-invasive ventilation

Procedure used for ventilation support in patients with congestive heart failure, pulmonary edema, COPD and some other conditions.

Intervention Type: PROCEDURE

Other Intervention Names

ventilator; neuromuscular block; continuous hemofiltration (CHF) or hemodiafiltration (CHDF); continuous positive airway pressure (CPAP)

Eligibility Criteria

Inclusion Criteria

• patients treated between June 1 2011 and June 29 2012 in the medical ICU

Exclusion Criteria

• Patients who stayed in the ICU less than 24 hours and
• hospital readmissions

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of Sarajevo

OTHER

Sponsor Role: lead

Responsible Party

Hajrunisa Cubro

MD

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Hajrunisa Cubro, MD

Role: PRINCIPAL_INVESTIGATOR

Medical ICU University of Sarajevo Clinical Center, Sarajevo, Bosnia and Herzegovina

Ognjen Gajic, MD, MSc

Role: STUDY_CHAIR

Division of Pulmonary and Critical Care Mayo Clinic Rochester MN USA

Other Identifiers

CCUS-2435/11

Identifier Type: -

Identifier Source: org_study_id