Understanding economic outcomes in critical care

PURPOSE OF REVIEW: The high costs of critical illness make economic outcomes important adjuncts to clinical outcomes in intensive care unit research. Costs are markedly different than other clinical outcomes, both in their measurement and their interpretation. RECENT FINDINGS: Although not necessarily patient-centered, economic outcomes are important to society. Costs are also useful summary measures of less-meaningful surrogates such as organ failures and lengths of stay. Limitations of economic outcomes, however, are numerous. Accurate measurement of costs in the ICU requires a thorough consideration of both direct and indirect costs, an understanding of the fixed and variable components of critical care expenditures, and knowledge that reducing resource use saves only the marginal, versus average, cost of ICU resources. Costs must also be interpreted alongside measures of effectiveness using proper modeling techniques. Interpretation can vary based on choice of effectiveness measure, perspective of the analysis, and societal and cultural norms. SUMMARY: When correctly measured and interpreted alongside measures of effectiveness, costs are a useful and important outcome in critical care research.