The Financial Impact of Post Intensive Care Syndrome

Abstract

This review explores the financial consequences that survivors of critical illness often face following hospitalization in an intensive care unit (ICU). As part of the "post-intensive care syndrome" (PICS), these survivors often experience, in addition to physical and emotional challenges of PICS, major financial burdens resulting from their prolonged ICU treatments. The escalating costs of ICU care, coupled with the potential long-term effects on survivors' ability to work and maintain financial stability, have brought financial toxicity to the forefront of health care discussions. The current review examines the causes and consequences of financial toxicity.

Keywords: Critical illness; Employment; Financial burden; Intensive care unit.

Fig. 1.

Financial toxicity after intensive care: Risk factors, measures, and consequences.

Fig. 2.

Proportion of survivors returning to work after critical illness, among 38 studies with discrete follow-up time points. Black squares represent pooled proportions (with 95% confidence interval) by that time point: 36% (23%–49%) by 1 to 3 months, 64% (52%–75%) by 6 months, 60% (50%–69%) by 12 months, 63% (44%–82%) by 18 to 36 months, and 68% (51%–85%) by 42 to 60 months. Pooled estimates calculated using random-effects meta-regression. For the 3 pairs of estimates falling within the same follow-up stratum, only the final follow-up point estimate was included. Bubbles represent 53 point estimates from the 38 studies, with bubble size corresponding to study sample size.

Fig. 3.

Cumulative incidence of returning to work over 12 month follow-up, stratified by age and race, with retirement and death treated as competing risks. (Reprinted with permission of the American Thoracic Society.