Abstract
Objective
To conduct a narrative review on the evolution of intensive care and the cost of intensive
care services in Australia.
Review method
A narrative review using a search of online medical databases and grey literature
with keyword verification via Delphi-technique.
Data sources
Using Medical Subject Headings and keywords (intensive care, critical care, mechanical
ventilation, renal replacement therapy, extracorporeal membrane oxygenation, monitoring,
staffing, cost, cost analysis) we searched MEDLINE, PubMed, CINAHL, Embase, Google
and Google Scholar.
Results
The search yielded 30 articles from which we provide a narrative synthesis on the
evolving intensive care practice in relation to key service elements and therapies.
For the review of costs, we found five relevant publications and noted significant
variation in methods used to cost ICU. Notwithstanding the limitations of the methods
used to cost all publications reported staffing as the primary cost driver, representing
up to 71% of costs.
Conclusion
Intensive care is a highly specialised medical field, which has developed rapidly
and plays an increasingly important role in the provision of hospital care. Despite
the increasing importance of the specialty and the known resource intensity there
is a paucity of data on the cost of providing this service. In Australia, staffing
costs consistently represent the majority of costs associated with operating an ICU.
This finding should be interpreted cautiously given the variation of methods used
to cost ICU services and the limited number of available studies. Developing standardised
methods to consistently estimate ICU costs which can be incorporated in research into
the cost-effectiveness of alternate practice is an important step to ensuring cost-effective
care.
Keywords
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Article Info
Publication History
Published online: September 26, 2017
Accepted:
August 11,
2017
Received in revised form:
August 1,
2017
Received:
June 27,
2016
Identification
Copyright
© 2017 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
