Kosilek, R.P.* ; Baumeister, S. ; Ittermann, T.* ; Gründling, M.* ; Brunkhorst, F.M.* ; Felix, S.B.* ; Abel, P.* ; Friesecke, S.* ; Apfelbacher, C.* ; Brandl, M.* ; Schmidt, K.* ; Hoffmann, W.* ; Schmidt, C.O.* ; Chenot, J.F.* ; Völzke, H.* ; Gensichen, J.S.*
     
 
    
        
The association of intensive care with utilization and costs of outpatient healthcare services and quality of life.
    
    
        
    
    
        
        PLoS ONE 14:e0222671 (2019)
    
    
    
		
		
			
				BackgroundLittle 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.MethodsCross-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.ResultsICU 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.ConclusionsOur findings suggest that ICU treatment is associated with an increased utilization of outpatient specialist services, higher medication intake, and impaired quality of life.
			
			
				
			
		 
		
			
				
					
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        Publikationstyp
        Artikel: Journalartikel
    
 
    
        Dokumenttyp
        Wissenschaftlicher Artikel
    
 
    
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        Schlagwörter
        Resource Utilization; Survivors; Outcomes; Unit; Impact; Pharmacists; Icu; Population; Mortality; Euroqol
    
 
    
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        Sprache
        englisch
    
 
    
        Veröffentlichungsjahr
        2019
    
 
    
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        HGF-Berichtsjahr
        2019
    
 
    
    
        ISSN (print) / ISBN
        1932-6203
    
 
    
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	    Band: 14,  
	    Heft: 9,  
	    Seiten: ,  
	    Artikelnummer: e0222671 
	    Supplement: ,  
	
    
 
  
        
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            Verlag
            Public Library of Science (PLoS)
        
 
        
            Verlagsort
            Lawrence, Kan.
        
 
	
        
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        Peer reviewed
    
 
     
    
        POF Topic(s)
        30202 - Environmental Health
    
 
    
        Forschungsfeld(er)
        Genetics and Epidemiology
    
 
    
        PSP-Element(e)
        G-502900-001
    
 
    
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        Erfassungsdatum
        2019-09-26