Essential Emergency and Critical Care: A Cost-Effective Lifesaver in Resource-Limited Settings
When faced with a critical illness, access to life-saving treatment can mean the difference between recovery and death. However, in many parts of the world, resources for critical care are extremely limited. This raises a crucial question: where should investments in critical care go to make the most impact?
A recent study examined the cost-effectiveness of different levels of critical care in Tanzania, using COVID-19 as a case study. The researchers compared four approaches: no critical care, district hospital-level critical care, Essential Emergency and Critical Care (EECC), and advanced critical care (such as ventilators in intensive care units). Their goal was to determine which option provides the most value for money in saving lives and reducing disability.
What is EECC?
Essential Emergency and Critical Care (EECC) focuses on simple but effective interventions such as monitoring vital signs, providing oxygen therapy, and administering intravenous fluids. These treatments are relatively low-cost but can significantly improve survival chances for critically ill patients.
Key Findings: EECC Saves Lives and Money
The study used an economic model to measure cost-effectiveness by calculating the cost per disability-adjusted life year (DALY) averted. A lower cost per DALY averted indicates better value for money. The researchers found that:
EECC is cost-effective in 94–99% of cases compared to providing no critical care or district hospital-level critical care.
The cost-effectiveness ratio of EECC is as low as $14 per DALY averted, well below Tanzania’s willingness-to-pay threshold of $101 per DALY.
Advanced critical care, while beneficial, is cost-effective only 27–40% of the time, making it a less reliable investment in resource-limited settings.
Cost-effectiveness results published in Pharmaco Economics Vol. 7, pages 537–552, (2023)
What Does This Mean for Global Health?
For low-resource settings where critical care services are scarce, this study provides strong evidence that EECC should be a priority investment. The affordability and effectiveness of EECC make it a practical solution for improving survival rates, particularly during health crises like the COVID-19 pandemic.
While the study focused on COVID-19, the benefits of EECC likely extend to other conditions such as sepsis, pneumonia, and trauma. Further research is needed to explore how EECC could enhance care for a broader range of critical illnesses.
Conclusion
Investing in EECC is a cost-effective and impactful way to improve critical care in low-resource settings. By prioritizing simple yet essential interventions, healthcare systems can save more lives without breaking the budget. This study highlights the urgent need for governments and health organizations to support the expansion of EECC—because when it comes to critical care, sometimes the simplest solutions are the most powerful.