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The association of intensive care with utilization and costs of outpatient healthcare services and quality of life.
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- المؤلفون: Kosilek, Robert P.1 ; Baumeister, Sebastian E.2,3,4; Ittermann, Till4; Gründling, Matthias5; Brunkhorst, Frank M.6; Felix, Stephan B.7,8; Abel, Peter7; Friesecke, Sigrun7; Apfelbacher, Christian9,10; Brandl, Magdalena9; Schmidt, Konrad11,12; Hoffmann, Wolfgang4; Schmidt, Carsten O.4; Chenot, Jean-François4; Völzke, Henry4,8,13; Gensichen, Jochen S.1
- المصدر:
PLoS ONE. 9/20/2019, Vol. 14 Issue 9, p1-15. 15p.
- الموضوع:
- معلومة اضافية
- نبذة مختصرة :
Background: Little is known about outpatient health services use following critical illness and intensive care. We examined the association of intensive care with outpatient consultations and quality of life in a population-based sample. Methods: Cross-sectional analysis of data from 6,686 participants of the Study of Health in Pomerania (SHIP), which consists of two independent population-based cohorts. Statistical modeling was done using Poisson regression, negative binomial and generalized linear models for consultations, and a fractional response model for quality of life (EQ-5D-3L index value), with results expressed as prevalence ratios (PR) or percent change (PC). Entropy balancing was used to adjust for observed confounding. Results: ICU treatment in the previous year was reported by 139 of 6,686 (2,1%) participants, and was associated with a higher probability (PR 1.05 [CI:1.03;1.07]), number (PC +58.0% [CI:22.8;103.2]) and costs (PC +64.1% [CI:32.0;103.9]) of annual outpatient consultations, as well as with a higher number of medications (PC +37.8% [CI:17.7;61.5]). Participants with ICU treatment were more likely to visit a specialist (PR 1.13 [CI:1.09; 1.16]), specifically internal medicine (PR 1.67 [CI:1.45;1.92]), surgery (PR 2.42 [CI:1.92;3.05]), psychiatry (PR 2.25 [CI:1.30;3.90]), and orthopedics (PR 1.54 [CI:1.11;2.14]). There was no significant effect regarding general practitioner consultations. ICU treatment was also associated with lower health-related quality of life (EQ-5D index value: PC -13.7% [CI:-27.0;-0.3]). Furthermore, quality of life was inversely associated with outpatient consultations in the previous month, more so for participants with ICU treatment. Conclusions: Our findings suggest that ICU treatment is associated with an increased utilization of outpatient specialist services, higher medication intake, and impaired quality of life. [ABSTRACT FROM AUTHOR]
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