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A comparison of critical care research funding and the financial burden of critical illness in the United States*

Coopersmith, Craig M. MD, FCCM; Wunsch, Hannah MD, MSc; Fink, Mitchell P. MD, FCCM; Linde-Zwirble, Walter T.; Olsen, Keith M. PharmD, FCCM; Sommers, Marilyn S. RN, PhD; Anand, Kanwaljeet J. S. MBBS, DPhil, FCCM; Tchorz, Kathryn M. MD; Angus, Derek C. MD, MPH, FCCM; Deutschman, Clifford S. MD, FCCM

doi: 10.1097/CCM.0b013e31823c8d03
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Objectives: To estimate federal dollars spent on critical care research, the cost of providing critical care, and to determine whether the percentage of federal research dollars spent on critical care research is commensurate with the financial burden of critical care.

Design and Data Sources: The National Institutes of Health Computer Retrieval of Information on Scientific Projects database was queried to identify funded grants whose title or abstract contained a key word potentially related to critical care. Each grant identified was analyzed by two reviewers (three if the analysis was discordant) to subjectively determine whether it was definitely, possibly, or definitely not related to critical care. Hospital and total costs of critical care were estimated from the Premier Database, state discharge data, and Medicare data. To estimate healthcare expenditures associated with caring for critically ill patients, total costs were calculated as the combination of hospitalization costs that included critical illness as well as additional costs in the year after hospital discharge.

Measurements and Main Results: Of 19,257 grants funded by the National Institutes of Health, 332 (1.7%) were definitely related to critical care and a maximum of 1212 (6.3%) grants were possibly related to critical care. Between 17.4% and 39.0% of total hospital costs were spent on critical care, and a total of between $121 and $263 billion was estimated to be spent on patients who required intensive care. This represents 5.2% to 11.2%, respectively, of total U.S. healthcare spending.

Conclusions: The proportion of research dollars spent on critical care is lower than the percentage of healthcare expenditures related to critical illness. (Crit Care Med 2012; 40:–1079)

From the Emory Center for Critical Care and Department of Surgery (CMC), Emory University School of Medicine, Atlanta, GA; the Departments of Anesthesiology and Epidemiology (HW), Columbia University, New York, NY; the Department of Surgery (MPF), David Geffen School of Medicine UCLA, Los Angeles, CA; ZD Associates, LLC (WTL-Z), Perkasie, PA; the Department of Pharmacy Practice (KMO), University of Nebraska Medical Center, Omaha, NE; the School of Nursing and School of Medicine (MSS) and the Department of Anesthesiology and Critical Care (CSD), University of Pennsylvania School of Medicine, Philadelphia, PA; the Department of Pediatrics (KJSA), University of Tennessee Health Science Center, Memphis, TN; the Department of Surgery (KMT), Wright State University-Boonshoft School of Medicine, Dayton, OH; and the Department of Critical Care Medicine (DCA), University of Pittsburgh School of Medicine, Pittsburgh, PA.

*See also. p. 1337.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (http://journals.lww.com/ccmjournal).

The computer program to query the National Institutes of Health Computer Retrieval of Information on Scientific Projects database was written by full-time staff members of the Society of Critical Care Medicine who provided the raw material to the research team.

Dr. Anand has a pending grant from Ikaria, Inc. and received royalties as book editor from Elsevier Publishers. The remaining authors have not disclosed any potential conflicts of interest.

For information regarding this article, E-mail: cmcoop3@emory.edu

© 2012 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins