A retrospective cohort study comparing differences in 30-day mortality among critically ill patients aged ≥ 70 years treated in European tax-based healthcare systems (THS) versus social health insurance systems

In Europe, tax-based healthcare systems (THS) and social health insurance systems (SHI) coexist. We examined differences in 30-day mortality among critically ill patients aged ≥ 70 years treated in intensive care units in a THS or SHI. Retrospective cohort study. 2406 (THS n = 886; SHI n = 1520) cri...

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Published in:Scientific reports 2022-10, Vol.12 (1), p.17460-9, Article 17460
Main Authors: Wernly, Bernhard, Flaatten, Hans, Beil, Michael, Fjølner, Jesper, Bruno, Raphael Romano, Artigas, Antonio, Pinto, Bernardo Bollen, Schefold, Joerg C., Kelm, Malte, Sigal, Sviri, van Heerden, Peter Vernon, Szczeklik, Wojciech, Elhadi, Muhammed, Joannidis, Michael, Rezar, Richard, Oeyen, Sandra, Wolff, Georg, Marsh, Brian, Andersen, Finn H., Moreno, Rui, Wernly, Sarah, Leaver, Susannah, Boumendil, Ariane, De Lange, Dylan W., Guidet, Bertrand, Perings, Stefan, Jung, Christian
Format: Article
Language:English
Subjects:
692/308/174
692/308/409
Cohort analysis
COVID-19
Critical Illness
Delivery of Health Care
Health care
Health insurance
Hospitals
Humanities and Social Sciences
Humans
Insurance, Health
Intensive care
Intensive Care Units
Intubation
Life Sciences
Mortality
multidisciplinary
Patients
Retrospective Studies
Santé publique et épidémiologie
Science
Science (multidisciplinary)
Sensitivity analysis
Taxation
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Summary:In Europe, tax-based healthcare systems (THS) and social health insurance systems (SHI) coexist. We examined differences in 30-day mortality among critically ill patients aged ≥ 70 years treated in intensive care units in a THS or SHI. Retrospective cohort study. 2406 (THS n = 886; SHI n = 1520) critically ill ≥ 70 years patients in 129 ICUs. Generalized estimation equations with robust standard errors were chosen to create population average adjusted odds ratios (aOR). Data were adjusted for patient-specific variables, organ support and health economic data. The primary outcome was 30-day-mortality. Numerical differences between SHI and THS in SOFA scores (6 ± 3 vs. 5 ± 3; p  = 0.002) were observed, but clinical frailty scores were similar (> 4; 17% vs. 14%; p  = 0.09). Higher rates of renal replacement therapy (18% vs. 11%; p  
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-022-21580-y