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The Effect on Overall Cost and Health-Related Quality of Life by Inpatient Trajectories 3 Years Before and After Critical Illness
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping.
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
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2016 (English)In: Journal of Anesthesia & Intensive Care Medicine, Vol. 1, no 1, 001-009 p., 555553Article in journal (Refereed) Published
Abstract [en]

Background: Pre-existing disease is the most important factor in the prediction of health-related quality of life (HRQoL) after intensive care. We hypothesised that the "inpatient care trajectories" in the years before admission to the ICU is a stronger predictor of HRQoL and mortality after intensive care than pre-existing disease, and that it has significant effects on overall costs.

Method: A retrospective investigation in two combined medical and surgical ICUs in Sweden. Inpatient care was assessed from the County administrative registry. HRQoL (SF-36) was measured at 6, 12, 24, and 36 months after discharge.

Results: Of 1092 patients, 459 (73%) had pre-existing diseases, and among them 360 (57%) had at least one inpatient episode less than 3 years before the ICU period, during which the group used significantly more hospital resources than the combined cost for all ICU care during the same time. The addition of episodes of inpatient care to the regression model strongly reduced the effect of pre-existing disease on HRQoL and was also a strong predictor for early mortality after ICU.

Conclusions: Episodes of inpatient care before admission to ICU uses considerable hospital resources, affects mortality and is a better predictor of HRQoL than diagnoses of pre-existing disease.

Place, publisher, year, edition, pages
Juniper Publishers , 2016. Vol. 1, no 1, 001-009 p., 555553
Keyword [en]
Long-term survival; Health-related quality of life; Hospital inpatient care episodes; Intensive Care; Mortality; Pre-existing diseases
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:liu:diva-130362OAI: oai:DiVA.org:liu-130362DiVA: diva2:952086
Available from: 2016-08-11 Created: 2016-08-03 Last updated: 2016-08-16

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Orwelius, LottiHusberg, MagnusBernfort, LarsCarlsson, PerFredrikson, MatsWalther, StenSjöberg, Folke
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Division of Clinical SciencesFaculty of Medicine and Health SciencesDepartment of Anaesthesiology and Intensive Care in LinköpingDivision of Health Care AnalysisDivision of Neuro and Inflammation ScienceDepartment of Thoracic and Vascular SurgeryDepartment of Hand and Plastic Surgery
Health Care Service and Management, Health Policy and Services and Health Economy

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