ICU Management & Practice, ICU Volume 7 - Issue 2 - Summer 2007

Cost Effectiveness in Care

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Jean-Louis Vincent

Head, Department of Intensive Care, Erasme

Hospital Free University of Brussels,



Quality of care has always been our primary goal as critical care professionals. We strive daily to find yet new methods and treatments to increase our effectiveness so that we save or improve as many lives as possible. However, there is always one drawback to quality that we have to overcome continuously. Whatever new and astounding technologies there might be, whatever novel treatments and drugs become available, there is always the restriction of budgeting and our goal is to make the best out of what we have in order to achieve the highest standards of care. With budgets always tighter, funding is becoming even harder to find. We in ICU Management recognise this ongoing struggle for the managers of critical care of meeting high costs while providing the finest quality care and we have devoted this issue to the subject of cost effectiveness.


In this issue of ICU Management, Dominique Vandijck and colleagues from the Intensive Care Department, University of Ghent describe the comprehensive management tool of Cost-Effectiveness Analysis when applied to the intensive care unit (ICU), whereby two clinical practices or new technologies can be compared in order for the most beneficial and cost-effective one to effectively be selected. Furthermore, Dr. Capuzzo compares costs of intermediary care units with those of ICUs, Dr. Csomos describes Diagnostic Related Group funding and its potential future  for critical care, and Dominique Vandijck and colleagues conclude our Cover Story by an article on the economic impact of catheter-related bloodstream infections.


As usual, in this issue of your management and best practice journal, you will find a number of interesting and enlightening articles focused on management. Drs. Pauldine and Dorman introduce a series on the topic of change management in the ICU, headed by a recognition of the sources of and barriers to change in critical care. Dr. Claudio Ronco, a leading name in nephrology and intensive care, shares his knowledge and experience with ICU Management. We also look at Poland and its healthcare and intensive care systems. Do not miss the preview for this year’s European Society of Intensive Care Medicine’s annual congress, combined with the Society’s “silver anniversary”, in Berlin.


We are also glad to announce the launch of our new rubric Forum, which will provide a platform for continuous discussion of critical care practices, new products and technologies, and controversial issues. We begin with an article by Dr. Billiet, which was submitted as a response to a previous article that appeared in a 2005 issue of ICU Management – “Performance evaluation of European pressure sensors” by Dr. Cochard. For future articles under this heading, we will count on your experience, knowledge and research. If you feel that you can contribute to the critical care Forum created by ICU Management, please do not hesitate to contact our editorial team for support.


The world of critical care management is more dynamic than ever and we must learn to meet every new challenge that we are faced with. To provide better quality care while managing our budgets effectively, we need to learn and incorporate complex management techniques. Therefore, this issue of ICU Management will provide you with a glance over cost effectiveness in critical care and we hope that we can continue helping you in your struggle for quality.

Author<br> Jean-Louis Vincent Head, Department of Intensive Care, Erasme Hospital Free University of Brussels, Belgium &nbsp; Quality of care ha

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