Cost awareness among intensivists in their daily clinical practice: a prospective multicentre study.

IF 3.1 3区 医学 Q1 ECONOMICS
European Journal of Health Economics Pub Date : 2024-12-01 Epub Date: 2024-03-13 DOI:10.1007/s10198-024-01686-y
Timothée Lehut, Céline Lambert, Romain Mortier, Emmanuel Futier, Russell Chabanne, Ulrich Bauer, Philippe Verdier, Ramin Ravan, Philippe Ocquidant, Charline Mourgues, Alexandre Lautrette
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引用次数: 0

Abstract

Background: Better cost-awareness is a prerogative in achieving the best benefit/risk/cost ratio in the care. We aimed to assess the cost-awareness of intensivists in their daily clinical practice and to identify factors associated with accurate estimate of cost (50-150% of the real cost).

Methods: We performed a prospective observational study in seven French ICUs. We compared the estimate of intensivists of the daily costs of caring with the real costs on a given day. The estimates covered five categories (drugs, laboratory tests, imaging modalities, medical devices, and waste) whose sum represented the overall cost.

Results: Of the 234 estimates made by 65 intensivists, 70 (29.9%) were accurate. The median overall cost estimate (€330 [170; 620]) was significantly higher than the real cost (€178 [124; 239], p < 0.001). This overestimation was found in four categories, in particular for waste (€40 [15; 100] vs. €1.1 [0.6; 2.3], p < 0.001). Only the laboratory tests were underestimated (€65 [30; 120] vs. €106 [79; 138], p < 0.001). Being aware of the financial impact of prescriptions was factor associated with accurate estimate (OR: 5.05, 95%CI:1.47-17.4, p = 0.01). However, feeling able to accurately perform estimation was factor negatively associated with accurate estimate (OR: 0.11, 95%CI: 0.02-0.71, p = 0.02).

Conclusion: French intensivists have a poor awareness of costs in their daily clinical practice. Raising awareness of the financial impact of prescriptions, and of the cost of laboratory tests and waste are the main areas for improvement that could help achieve the objective of the best care at the best cost.

重症监护医师在日常临床实践中的成本意识:一项前瞻性多中心研究。
背景:提高成本意识是实现最佳效益/风险/成本比的前提条件。我们的目的是评估重症监护医师在日常临床实践中的成本意识,并确定与准确估算成本(实际成本的 50-150% )相关的因素:我们在法国七家重症监护病房开展了一项前瞻性观察研究。方法:我们在法国的七家重症监护病房进行了前瞻性观察研究。我们将重症监护医师对每日护理成本的估算与特定日期的实际成本进行了比较。估算包括五个类别(药物、实验室检查、成像方式、医疗设备和废物),其总和代表总成本:结果:在 65 名重症监护医生做出的 234 项估算中,有 70 项(29.9%)是准确的。总体成本估算的中位数(330 欧元 [170; 620])明显高于实际成本(178 欧元 [124; 239],P 结论:法国的重症监护医生对总体成本的认识不足:法国的重症监护医生在日常临床实践中对成本认识不足。提高对处方的经济影响、化验成本和浪费的认识是需要改进的主要方面,这有助于实现以最佳成本提供最佳医疗服务的目标。
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来源期刊
CiteScore
6.10
自引率
2.30%
发文量
131
期刊介绍: The European Journal of Health Economics is a journal of Health Economics and associated disciplines. The growing demand for health economics and the introduction of new guidelines in various European countries were the motivation to generate a highly scientific and at the same time practice oriented journal considering the requirements of various health care systems in Europe. The international scientific board of opinion leaders guarantees high-quality, peer-reviewed publications as well as articles for pragmatic approaches in the field of health economics. We intend to cover all aspects of health economics: • Basics of health economic approaches and methods • Pharmacoeconomics • Health Care Systems • Pricing and Reimbursement Systems • Quality-of-Life-Studies The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfill the above-mentioned requirements. Officially cited as: Eur J Health Econ
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