DIRECT COSTS OF MEDICAL CARE FROM INTENSIVE CARE UNITS IN COLOMBIA

• Published in: Value in health Vol. 20; no. 5; p. A372
• Main Authors: Tanus, A Florez, Arnedo, C Marrugo, de la Rosa, F Gomez, Pájaro, K Lopez, Jayutt, G Mora, Granados, E Mazenett, Castell, C Dueñas, Guzman, N Alvis
• Format: Journal Article
• Language: English
• Published: Lawrenceville Elsevier Science Ltd 01.05.2017
• Subjects: Averages; Cancer; Consumption; Costing; Health care; Health care expenditures; Health insurance; Health services; HIV; Hospitals; Human immunodeficiency virus; Inpatient care; Insurance companies; Intensive care; Intensive care units; Medical diagnosis; Perinatal; Purchasing power parity; Resource allocation; Trauma; Tumors; Colombia
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2017.05.005

OBJECTIVES: To estimate the direct medical costs of inpatient care, in Intensive Care Units (ICU) from a Colombian government subsidized health insurer. METHODS: A sample of 9,763 inpatients from intensive care units distributed in 726 hospitals in 2015. Direct costs of medical care were calculated from the third party payer's perspective, with the micro-costing technique and the bottom-up methodology. Annual average costs were estimated by diagnosis groups and cost centers. Results are shown in international dollars adjusted for purchasing power parity (PPP). RESULTS: ICU care represents 13.4% [CI 13.2 - 13.6] of total hospital events and 24.3% [CI 24.19% - 24.42%] of bed days. Cost in ICU amount to 130.5 million PPP$ which represents 16.4% of the insurer total cost. The most important diagnoses in the ICU cost were: Cardiovascular 23.1%, Perinatal conditions 16.9%, Respiratory 13.3%, Parasitic infections 10.4% and trauma 5.3%. The diagnoses from ICU with the highest cost per stay day were: Cancer - 1,160.7 PPP$ [IQR 779.1-1,656.8]; HIV- 1,127.6 PPP$ [IQR 713.5-1.834.4]; Trauma - 1,103.8 PPP$ [IQR 655-1,744.3]; Benign tumors - 1.065.2 PPP$ [IQR 615.7-1.537.1] and Respiratory-chronic - 1.017.5 PPP$ [IQR 635.8-1.531.2]. Hospital stay, medications, diagnostic aids and medical procedures represents 41.2%, 38.3%, 10.2% and 7.4% of the ICU costs respectively. The highest average age group corresponds to people between 15 and 44 years old (mean = 1,198 PPP$ and median = 968.9 PPP$) mainly explained by the high impact of gestational care in women and trauma in men CONCLUSIONS: Identifying spending patterns and health services consumption in ICUs, are fundamentals for a planning and efficient allocation of resources in insurance companies.