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The association of intensive care with utilization and costs of outpatient healthcare services and quality of life

Author

Listed:
  • Robert P Kosilek
  • Sebastian E Baumeister
  • Till Ittermann
  • Matthias Gründling
  • Frank M Brunkhorst
  • Stephan B Felix
  • Peter Abel
  • Sigrun Friesecke
  • Christian Apfelbacher
  • Magdalena Brandl
  • Konrad Schmidt
  • Wolfgang Hoffmann
  • Carsten O Schmidt
  • Jean-François Chenot
  • Henry Völzke
  • Jochen S Gensichen

Abstract

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.

Suggested Citation

  • Robert P Kosilek & Sebastian E Baumeister & Till Ittermann & Matthias Gründling & Frank M Brunkhorst & Stephan B Felix & Peter Abel & Sigrun Friesecke & Christian Apfelbacher & Magdalena Brandl & Konr, 2019. "The association of intensive care with utilization and costs of outpatient healthcare services and quality of life," PLOS ONE, Public Library of Science, vol. 14(9), pages 1-15, September.
    • Handle: RePEc:plo:pone00:0222671
    DOI: 10.1371/journal.pone.0222671
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    References listed on IDEAS

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