OBJECTIVES: Direct medical costs incurred during ICU hospitalization are particularly relevant due to their high cost to health system. This study aimed to evaluate the economic burden of diseases and injuries incurred during ICU admissions in a low-income country (Brazil), during the pandemic.

METHODS: Epidemiological data and patient-level costs were collected from 10 ICUs from all Brazilian regions, between January/2020 to December/2021. Data was extracted from the Impacto-MR, a collaborative research platform coordinated by six Brazilian hospitals, including Hospital Israelita Albert Einstein, in partnership with the Ministry of Health and the National Health Surveillance Agency(ANVISA). A standardized absorption methodology was developed from the hospital perspective to measure ICU admissions’ costs. Measured cost components included ICU staff, depreciation, electricity, water, telephone, internet, medical gases, overheads, drugs, office and medical supplies, hemodialysis, blood transfusions, and lab/imaging tests. Clinical conditions were classified following the Global Burden of Diseases standards.

RESULTS: Non-communicable diseases (i.e. cardiovascular, and chronic respiratory diseases, cancer, etc.) were the main cause with 58.4% of total economic burden of US$ 81 million, followed by communicable, maternal, neonatal, and nutritional diseases, with 28.2%. Considering level2, Respiratory infections and tuberculosis incurred the highest costs for both men and women, accounting for 22.0% of total economic burden and a median cost of US$7,146/patient, mostly associated with COVID-19. Cardiovascular (16.9%) and digestive diseases (12.1%) incurred as the next higher costs. For all diseases and injuries, the cost of ICU staff was the highest, followed by overhead and drugs.

CONCLUSIONS: More than half of the economic burden of ICUs is associated with non-communicable diseases. However, respiratory infections and tuberculosis were the cause that absorbed the most resources in 2020 and 2021. The economic burden of diseases and injuries is dynamic and regular monitoring can help prioritize interventions and improve the allocation of limited resources.