Section on Health Services Research and Outcome

Section on Health Services Research and Outcome

Section on Health Services Research and Outcome /

Maurizia Capuzzo, Chairman

Andreas Valentin, Deputy

Minutes of Working Group on Health Economics Meeting

Held on the 12th October 2010 at the ESICM Congress in Barcelona

Date:Wednesday, 12th October 2010

Time:14.00 – 15.00

Location:Room BM5


Attendants: Antonio Artigas, Eric Bloomfield, Maurizia Capuzzo, Didier Ledoux, Paolo Maia, Paolo Merlani, Hajo Reissmann, Dierk Vagts.

Paolo Merlani opened the meeting and welcomed the participants. He then presented the agenda of the meeting.

The ELOISE project was then discussed. Paolo Merlani mentioned that because he has not enough time to finalise the project he asked Didier Ledoux to continue the project development. Didier Ledoux then briefly summarized the project protocol. Some issues on the project protocol were than raised by the attendees:

- Gaetano Iapichino who could not attend the meeting made a comment by email on the LOC III definition suggesting deleting the words “at risk”. It was decided to adapt the LOC III definition according to the one the Working Group on Basic Requirements (WG on BR) will term. The WG on BR meeting occurred on the next day and it was decided there to accept Gaetano Iapichino proposition.

- Antonio Artigas asked whether the population of interest included those patients who, during their hospital stay, were admitted to the IMCU but who did not go to the ICU? Paolo Merlani clarified this issue making it clear that the population of interest was patients who required ICU during their hospital stay.

- Antonio Artigas also had remarks on the number of ICU needed to have a representative picture of ICUs at the country level. He further insisted on the fact that it will not be possible to have such picture at country level centres should be drawn at random. This possible study bias was acknowledged.

- Antonio Artigas observed that the protocol did not mention how data quality assessment will be organized. Maurizia Capuzzo agreed with this and proposed to follow data quality assessment method of the SAPS 3 study, i.e. rescore a random sample (5%) of patients’ data.

- Antonio Artigas then brought up the issue of cost assessment. He wondered if a real cost assessment would be necessary. This could be done using the cost block method described by David Edbrooke et al.. Maurizia Capuzzo said that, since several authors showed that ICU length of stay (LOIS) was a valid proxy of cost, we could keep the LOIS approach. However this approach need to be better described and more references need to be added in the protocol.

After comments and suggestions on the study protocol, Didier Ledoux presented the Hospital/ICU/IMCU questionnaire. Various suggestions were made:

- Type of hospital: it was decided to also consider university affiliated and teaching hospitals as university hospital.

- Use of recovery rooms: the question on the use of RR for purpose other than normal postoperative care was reformulated:

Do you keep or admit and treat patients in the recovery rooms when there is no ICU bed available? / Regularly
Less than once a week

- A question about medical staff dedicated to IMCU and their qualification was added.

For time reasons, the overview of the questionnaire could not be finished. Questionnaire and patient’s form will be finalised together with the steering committee. It was also decided that data collection will be based on excel files, with a multiple choice data entry.

The financing/support issue was discussed. Everyone agreed that we should apply for an ESICM support.

Finally, Paolo Merlani discussed of the Health Economics Working Group. Considering that the ELOISE project and the lead of the working group were linked, Paolo Merlani proposed Didier Ledoux as PI and head of the WG, which was approved by the attendees.

The working Group meeting ended at 15:00.

The next meeting will be held at the ISICEM congress in Brussels.

Date and location will be communicated as soon as possible.

Paolo Merlani Didier Ledoux