How Many Intensive Care Beds are Justifiable for Hospital Pandemic Preparedness? A Cost-effectiveness Analysis for COVID-19 in Germany.
Appl Health Econ Health Policy
; 19(2): 181-190, 2021 03.
Article
in English
| MEDLINE | ID: covidwho-1023373
ABSTRACT
INTRODUCTION:
Germany is experiencing the second COVID-19 pandemic wave. The intensive care unit (ICU) bed capacity is an important consideration in the response to the pandemic. The purpose of this study was to determine the costs and benefits of maintaining or expanding a staffed ICU bed reserve capacity in Germany.METHODS:
This study compared the provision of additional capacity to no intervention from a societal perspective. A decision model was developed using, e.g. information on age-specific fatality rates, ICU costs and outcomes, and the herd protection threshold. The net monetary benefit (NMB) was calculated based upon the willingness to pay for new medicines for the treatment of cancer, a condition with a similar disease burden in the near term.RESULTS:
The marginal cost-effectiveness ratio (MCER) of the last bed added to the existing ICU capacity is 21,958 per life-year gained assuming full bed utilization. The NMB decreases with an additional expansion but remains positive for utilization rates as low as 2%. In a sensitivity analysis, the variables with the highest impact on the MCER were the mortality rates in the ICU and after discharge.CONCLUSIONS:
This article demonstrates the applicability of cost-effectiveness analysis to policies of hospital pandemic preparedness and response capacity strengthening. In Germany, the provision of a staffed ICU bed reserve capacity appears to be cost-effective even for a low probability of bed utilization.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Bed Occupancy
/
Planning Techniques
/
COVID-19
/
Intensive Care Units
Type of study:
Experimental Studies
/
Observational study
Limits:
Humans
Country/Region as subject:
Europa
Language:
English
Journal:
Appl Health Econ Health Policy
Journal subject:
Public Health
/
Health Services
Year:
2021
Document Type:
Article
Affiliation country:
S40258-020-00632-2
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