ABSTRACT
The patient census in the critical care unit and, in particular, the expanded use of mechanical ventilation, can be used to explain some of the growth in health care costs in the United States relative to other countries. It has been estimated that critical care in the US accounts for 20 to 34 percent of all hospital costs, and 7 to 8 percent of total health care expenditures in the economy (Jacobs and Noseworthy 1990; SCCM 1992). Patients requiring prolonged mechanical ventilation in the critical care unit consume as much as 50 percent of critical care resources despite the fact that this population may represent fewer than 10 percent of all critical care unit patients (Wagner 1989; Booth and Cohen 1994; Cohen and Booth 1994). Given the intensity and dominance of mechanical ventilation in the critical care unit, these services will be used to illustrate the economic evaluation of critical care resource utilization among the seriously ill elderly.
