Economics of Using Biocidal Surfaces - Use of Biocidal Surfaces for Reduction of Healthcare Acquired Infections - page 167

estimation of Quality of Life after leaving the ICU adds more parameters to
the effort of a total economic assessment [ 18 ].
The use of both technical materials and methods to minimize the parameters
that increase the cost of hospitalization in ICU is presented and analyzed in this
chapter.

8.2 Evaluation of ICU Cost Effectiveness

The ICUs host patients with multiple problems and medical interventions,
thus their treatment is often supportive up to the final stage. Over 50 years in
hospitals around the world these units are the main section dealing with the most
difficult cases.
A key issue that emerges is the definition of an “ICU bed”. American definitions
reflect the intensity of physician staff (for example, nurse to patient ratio, intensity
of physician staffing). In contrast, definitions of ICU beds in Belgium reflect the
intensity of the illness and focus on the ability to care for patients with specific
severities of illness (that is, organ dysfunction), [ 15 , 23 ].
The variability of definition of intensive care (different staffing intensity,
different patient type, or acuity) clearly impacts the ability to compare different
types of care for critically ill patients. Even without universal definition of an
ICU bed, however, the variation in availability of any type of ICU bed remains
large [ 15 ].
Understanding of the different ways of economic analysis most often complicates
the final assessment and creates difficulties in researchers communicating.
The following table shows examples of financial formulas as recorded in Report
from the Second American Thoracic Society Workshop on Outcome Research.
(Table 8.1 - Report from the 2nd American Thoracic Society Workshop June 2001).
One of the questions that usually arise of the economic evaluation of the
functioning of Critical Care Units is “What is the cost to achieve that effect?”.
However, from our point of view, there are other questions that should be
answered in the context of an ICU's economic assessment, such as:

• Is it patient's survival?
• Is it quality of life until death?
• Are there any technical terms such as hospitalization days' reduction?
• Is it the cost of pharmaceutical expenditure reduction?

• Is it the infections' reduction?

• Is it all the above?

It is also important to understand the difference between efficacy (can it work?),
effectiveness (does it work in reality and clinical practice?), as well as and cost
effectiveness (the consequences of the alternatives are measured in natural units,
such as years of life gained. The consequences are not given a monetary value).