First Author: Richard Pugh, MBChB MSc FRCA FFICM – Glan Clwyd Hospital Co-Author: Laura Herbert, MS – Senior Analyst, Swansea University Co-Author: Paul Twose, PhD – Physiotherapist, Cardiff and Vale UHB Co-Author: Stuart Bedston, N/A – Senior Research Office and Data Scientist, Swansea University Co-Author: Ashley Akbari, N/A – Professor, Swansea University
Introduction: Critical care follow-up clinics aim to support recovery and reduce avoidable healthcare use among ICU survivors. Despite national recommendations, access and structure of these clinics vary across Wales (UK), and population-level evidence on their impact remains limited. Our objectives were to evaluate the role of critical care follow-up clinics in Wales by examining patient characteristics associated with clinic attendance and assessing differences in healthcare resource utilisation (HRU) during the first year post-discharge.
Methods: We conducted a retrospective population-level cohort study using anonymised, linked administrative data from the Secure Anonymised Information Linkage (SAIL) Databank. Patients were categorised into three groups: invited and attended, invited but did not attend, and not invited (due to lack of clinic provision). HRU metrics included critical care readmissions, GP events, emergency department attendances, outpatient appointments, hospital admissions (emergency and elective), and inpatient bed days. Conditional logistic regression models were used to assess associations between clinic attendance and HRU, adjusting for demographic and clinical covariates. Pseudo-attendance dates were imputed for non-attenders to standardise follow-up periods.
Results: Between October 2016 and June 2023, there were 76,478 adult admissions to Welsh ICUs. Data was available for three of the five Welsh Health Boards offering critical care follow-up services and included 2450 patients invited to follow-up clinic; 792 patients attended clinic and 1658 did not. The not-invited patient group was matched to the collective invited group to allow balanced representation across age groups, comorbidity and admission year. Results are currently undergoing internal review and will be presented in full at the SCCM conference, offering timely insights into post-ICU recovery pathways.
Conclusions: This is the first population-level evaluation of critical care follow-up clinics in the UK. The findings will contribute to understanding the variability in clinic provision and attendance, and inform future service development to optimise post-critical care recovery and resource use.
