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ObjectiveTo establish the prevalence of physical, cognitive and psychiatric disabilities, associated factors and their relationship with the qualities of life of intensive care survivors in Brazil.MethodsA prospective multicenter cohort study is currently being conducted at 10 adult medical-surgical intensive care units representative of the 5 Brazilian geopolitical regions. Patients aged ≥ 18 years who are discharged from the participating intensive care units and stay 72 hours or more in the intensive care unit for medical or emergency surgery admissions or 120 hours or more for elective surgery admissions are consecutively included. Patients are followed up for a period of one year by means of structured telephone interviews conducted at 3, 6 and 12 months after discharge from the intensive care unit. The outcomes are functional dependence, cognitive dysfunction, anxiety and depression symptoms, posttraumatic stress symptoms, health-related quality of life, rehospitalization and long-term mortality.DiscussionThe present study has the potential to contribute to current knowledge of the prevalence and factors associated with postintensive care syndrome among adult intensive care survivors in Brazil. In addition, an association might be established between postintensive care syndrome and health-related quality of life.

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Health care financing has become a topic on the political agenda in Western Europe in recent decades.For every government it has become a subject of continuous concern because the costs of health services and health care are an increasing important part of the collective burden of the economy.Most cost containment measures have relied on budgeting or price controls.Because those traditional central cost containment measures were only partially successful, due to lack of incentives, the health authorities in Europe started to establish incentives for efficient health care delivery by means of decentralisation of the health care decision-making process and the implementation of market mechanisms.Both traditional and recent containment measures focus especially on the pharmaceutical drugs sector in many countries.Recently there have been three parallel trends showing increasing data requirements at a central level, more decentralisation of the responsibilities and decision-making process and prescription restrictions.We address especially the increasing central data requirements and decentralisation of the pricing and/or reimbursement decision-making process.At a central level the demand is increasing for cost-effectiveness and budgetary impact data, which has already resulted in formal reporting requirements in some countries. The findings are based on the literature and Original papers HEPAC 2001 · 2:162-169