Table 3.
High-cost interventions, cost, and outcomes.
| Example | Short term | Medium to long term | Outcomes |
|---|---|---|---|
| Intensive care for croup | High cost for intensive care (usually only a few days)—but extreme variability in the costs incurred (32) | No expected ongoing costs | Normal life expectancy, small proportion will have recurrent croup |
| Intensive care for Guillan–Barré syndrome | High cost for intensive care (may require months of ventilation) | May need high input for rehabilitation | Expected to return to normal quality of life with normal activities (may have residual weakness). Some patients have recurrent disease (33–35) |
| Intensive care for pneumonia or infection | High cost for intensive care (usually a few days but may be longer) | If not underlying disease, minimal long-term costs | Depending on context, may have substantial mortality in hospital and in the 6 months following hospital discharge (36) [particularly if concurrent malnutrition (37)]. However, high chance of normal long-term outcome |
| Intensive care to enable major surgery | High cost for surgery and intensive care (usually only a few days) | Depending on underlying problems, may be a significant range of long-term costs | The outcomes of a major surgery can be very variable depending on a variety of factors including surgical training and surgical caseload |
| Surgery for congenital heart disease | High cost for surgery and intensive care | If curative surgery, then minimal long-term costs. May have substantial costs for ongoing care (38) in complex conditions | If successful, excellent outcomes with essentially normal life expectancy and quality of life |
| Surgery for rheumatic heart disease | High cost for surgery and intensive care | Relatively high costs for ongoing follow-up and medication | Limited long-term survival and high morbidity (39) |
| Surgery and Intensive care for trauma including burn injuries | Relatively high cost for surgery and intensive care | Depending on the site and extent of the injuries, the long-term costs could be minimal or very substantial | The outcomes may be variable. In the absence of long-term rehabilitation, and in the absence of facilities such as access to cadaver skin or expensive skin replacements, the outcomes of major burns may be extremely poor |