gms | German Medical Science

53. Kongress für Allgemeinmedizin und Familienmedizin

Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM)

Erlangen, 12. - 14.09.2019

Article

Send article

The association of intensive care with utilization and costs of outpatient healthcare services and quality of life: Results from two independent population-based cohorts

Meeting Abstract

Search Medline for

  • presenting/speaker Robert Philipp Kosilek - LMU München, Institut für Allgemeinmedizin, München, Deutschland
  • Sebastian Edgar Baumeister - LMU München, Lehrstuhl für Epidemiologie am UNIKA-T Augsburg, Deutschland
  • Till Ittermann - Universitätsmedizin Greifswald, Institut für Community Medicine, Greifswald, Deutschland
  • Matthias Gründling - Universitätsmedizin Greifswald, Klinik für Anästhesiologie, Greifswald, Deutschland
  • Frank Martin Brunkhorst - Universitätsklinikum Jena, Klinik für Anästhesiologie und Intensivmedizin, Jena, Deutschland
  • Stephan B. Felix - Universitätsmedizin Greifswald, Innere Medizin B, Greifswald, Deutschland
  • Peter Abel - Universitätsmedizin Greifswald, Innere Medizin B, Greifswald, Deutschland
  • Sigrun Friesecke - Universitätsmedizin Greifswald, Innere Medizin B, Greifswald, Deutschland
  • Christian Apfelbacher - Universität Regensburg, Institut für Epidemiologie und Präventivmedizin, Regensburg, Deutschland
  • Magdalena Brandl - Universität Regensburg, Institut für Epidemiologie und Präventivmedizin, Regensburg, Deutschland
  • Konrad Schmidt - Charité – Universitätsmedizin Berlin, Institut für Allgemeinmedizin, Berlin, Deutschland
  • Wolfgang Hoffmann - Universitätsmedizin Greifswald, Institut für Community Medicine, Greifswald, Deutschland
  • Carsten Oliver Schmidt - Universitätsmedizin Greifswald, Institut für Community Medicine, Greifswald, Deutschland
  • Jean-François Chenot - Universitätsmedizin Greifswald, Institut für Community Medicine, Greifswald, Deutschland
  • Henry Völzke - Universitätsmedizin Greifswald, Institut für Community Medicine, Greifswald, Deutschland
  • Jochen Stefan Gensichen - LMU München, Institut für Allgemeinmedizin, München, Deutschland

53. Kongress für Allgemeinmedizin und Familienmedizin. Erlangen, 12.-14.09.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocP08-01

doi: 10.3205/19degam166, urn:nbn:de:0183-19degam1664

Published: September 11, 2019

© 2019 Kosilek et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Background: Recent studies have indicated that intensive care unit (ICU) treatment is associated with long-term physical and neuropsychiatric impairments. Little is known about outpatient health services use following intensive care.

Objective: To examine the association of intensive care with outpatient health services utilization, costs and health-related quality of life in a population-based sample.

Methods: Cross-sectional analysis of data from a population-based study in northeastern Germany. Data on sociodemographic factors, medical history including ICU treatment and outpatient medical consultations, costs and quality of life (EQ-5D-3L) were obtained from 6,686 participants of the Study of Health in Pomerania (SHIP), which consist of two independent cohorts. Outpatient consultations were examined using prevalence ratios (PR) from Poisson regression. Number and costs of consultations were estimated using negative binomial and generalized linear models, expressed as percent change (PC). The EQ-5D index value was modeled using a fractional response model. 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.

Discussion: ICU treatment is associated with an increased utilization of outpatient specialist services, higher medication intake, and impaired quality of life.

Take home message for practical use: Post-ICU follow-up is a multi-disciplinary process.