Abstract
We assessed the effectiveness of our intensive care system in improving patient survival by developing a “life-saving score (LS)” derived from the APACHE II-predicted mortality ratio, in 100 consecutive adult ICU patients. Therapeutic intervention was assessed by a modified therapeutic intervention scoring system (TISS) incorporating utilization of equipment, materials, personnel and technical specialty necessary for ICU interventional procedures (IS). We used this information to make a cost-efficiency analysis of intensive care. LS was found to be useful in evaluating the quality of intensive care taking into account the severity of illness. IS was found to make characterization of the pattern of resource utilization possible. The cost-efficiency balance seemed to be the most satisfactory in central nervous system diseases and the least satisfactory in hepatometabolic diseases, but this may be misleading because of under- or over-estimation of mortality as predicted by the APACHE II system in these disease categories. However, the longitudinal application of our method of cost-efficiency analysis seems useful for obtaining quality assurance in individual ICUs.
