Effect of mortality prediction models on resource use benchmarking of intensive care units.

Moser, André; Raj, Rahul; Reinikainen, Matti; Jakob, Stephan M; Takala, Jukka (2024). Effect of mortality prediction models on resource use benchmarking of intensive care units. (In Press). Journal of critical care, 82(154814), p. 154814. Elsevier 10.1016/j.jcrc.2024.154814

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PURPOSE

Intensive care requires extensive resources. The ICUs' resource use can be compared using standardized resource use ratios (SRURs). We assessed the effect of mortality prediction models on the SRURs.

MATERIALS AND METHODS

We compared SRURs using different mortality prediction models: the recent Finnish Intensive Care Consortium (FICC) model and the SAPS-II model (n = 68,914 admissions). We allocated the resources to severity of illness strata using deciles of predicted mortality. In each risk and year stratum, we calculated the expected resource use per survivor from our modelling approaches using length of ICU stay and Therapeutic Intervention Scoring System (TISS) points.

RESULTS

Resource use per survivor increased from one length of stay (LOS) day and around 50 TISS points in the first decile to 10 LOS-days and 450 TISS in the tenth decile for both risk scoring systems. The FICC model predicted mortality risk accurately whereas the SAPS-II grossly overestimated the risk of death. Despite this, SRURs were practically identical and consistent.

CONCLUSIONS

SRURs provide a robust tool for benchmarking resource use within and between ICUs. SRURs can be used for benchmarking even if recently calibrated risk scores for the specific population are not available.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care
04 Faculty of Medicine > Pre-clinic Human Medicine > Department of Clinical Research (DCR)

UniBE Contributor:

Moser, André, Jakob, Stephan, Takala, Jukka

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0883-9441

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

22 Apr 2024 10:11

Last Modified:

23 Apr 2024 09:47

Publisher DOI:

10.1016/j.jcrc.2024.154814

PubMed ID:

38643569

Uncontrolled Keywords:

Cost control Health care benchmarking Health resources Hospital mortality Intensive care unit Resource allocation

BORIS DOI:

10.48350/196141

URI:

https://boris.unibe.ch/id/eprint/196141

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