Prognosis, Survival, and the Expenditure of Hospital Resources for Patients in an Intensive-Care Unit

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Abstract
To define more precisely the factors determining the allocation of resources to critically ill patients, we asked physicians to estimate at the time of admission the short-term prognosis of patients who accounted for 1831 admissions to a medical intensive-care and coronary-care unit. We then examined the relations between this prognosis, the actual outcome, and the resource expenditure during a single hospitalization. We found that the care of nonsurvivors involved a significantly higher mean expenditure than did the care of survivors (P<0.01). Among nonsurvivors, expenditure positively correlated with the probability of survival estimated at the time of admission (P<0.001). Among survivors, expenditure negatively correlated with the probability of survival (P<0.001). Among both nonsurvivors and survivors, total expenditure and expenditure per day were greatest for patients whose outcome were most unexpected.