Performing a costeffectiveness analysis (CEA) on a cohort of admissions during a crisis is only possible along the way or in retrospect. We included a series of ICU admitted patients from a teaching hospital in The Netherlands to perform a CEA , supposing a high mortality rate when not admitted to the ICU. Using this simple approach and without further selection of patients with relatively better prospects, this treatment seems not to fit within a priori willingness to pay levels presently used for deciding on other expensive curative treatments in The Netherlands. In view of the methodological, pandemic crisis related challenges, comments on this approach are however very welcome.

https://essay.utwente.nl/96654/

Abstract

Introduction: As a result of the COVID-19 pandemic, there high demand for intensive care (ICU) beds and a shortage of beds arose. The aim of this study is to investigate the cost-effectiveness of an ICU admission for treating COVID-19 versus general ward (GW) admission, together with a hypothetical situation where potential ICU patients did not go to the ICU (no-ICU).

Methodology: The health economic evaluation performed was a cost-effectiveness analysis, in which a model was developed that consisted of a decision tree and a Markov model with a time horizon of one year from hospital admission. The two scenarios investigated were (1) ICU versus GW admission and (2) ICU versus no-ICU admission. In the analysis healthcare costs and health utility values during hospital admission and after discharge were included. Incremental costs and effects were then calculated. The Dutch cost-effectiveness threshold of € 80,000 was used to evaluate if ICU was costeffective compared to GW and no-ICU based on the incremental cost-effectiveness ratio (ICER). Subgroup analysis based on gender, age (