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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 2 of 2 Research Studies DisplayedCollinsworth AW, Priest EL, Masica AL
Evaluating the cost-effectiveness of the ABCDE bundle: impact of bundle adherence on inpatient and 1-year mortality and costs of care.
This study examined the cost-effectiveness of the Awakening and Breathing Coordination, Delirium monitoring/management, and Early exercise/mobility (ABCDE) bundle intervention to improve short- and long-term clinical outcomes for patients requiring ICU care. A 2-year, prospective, cost-effectiveness study in 12 adult ICUs in six hospitals belonging to a large, integrated healthcare delivery system was conducted. Hospitals in the study included a large, urban center and five community hospitals. ICU types included medical/surgical, trauma, neurologic, and cardiac care units. The cohort included 2,953 adults with an ICU stay greater than 24 hours who were on a ventilator for more than 24 hours and less than 14 days. ICUs with high ABCDE bundle adherence significantly decreased odds of inpatient mortality and had significantly higher costs of inpatient care. The incremental cost-effectiveness ratio of high bundle adherence was $15,077 per life saved, and $1,057 per life-year saved.
AHRQ-funded; HS021459.
Citation: Collinsworth AW, Priest EL, Masica AL .
Evaluating the cost-effectiveness of the ABCDE bundle: impact of bundle adherence on inpatient and 1-year mortality and costs of care.
Crit Care Med 2020 Dec;48(12):1752-59. doi: 10.1097/ccm.0000000000004609..
Keywords: Intensive Care Unit (ICU), Critical Care, Mortality, Healthcare Costs
Khandelwal N, Engelberg RA, Hough CL
The patient and family member experience of financial stress related to critical illness.
Financial stress resulting from critical illness is a big problem in this country. This study’s objectives were to: 1) explore common financial concerns, their emotional stress, and potential opportunities for interventions to reduce financial stress in patients and their family; and 2) confirm patient and family members’ willingness to provide information on this topic. This cross-sectional survey study used patients from two prior randomized trials at an urban, level 1 Trauma center. The study surveyed 10 patients and 19 family members who reported financial worries during an intensive care unit (ICU) stay. Of the 70% of both groups who reported financial concerns post-ICU discharge, 30% of patients and 43% of family members who were not asked about their concerns by hospital staff wished they had been asked. Both groups felt it would have been helpful to have information about insurance coverage, interpreting hospital bills, and estimated out-of-pocked costs. Among patients, 47% favorited receiving these services after the ICU stay, while 20% preferred them during their ICU stay. Among family members, 73% preferred receiving them during the ICU stay while 27% preferred them after the patient came home.
AHRQ-funded; HS022982.
Citation: Khandelwal N, Engelberg RA, Hough CL .
The patient and family member experience of financial stress related to critical illness.
J Palliat Med 2020 Jul;23(7):972-76. doi: 10.1089/jpm.2019.0369..
Keywords: Patient Experience, Healthcare Costs, Critical Care