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Cost-effectiveness issues in ventilator-associated pneumonia
1Division of Trauma and Critical Care, University of Cincinnati Medical Center, PO Box 670558, 231 Albert Sabin Way, Cincinnati, Ohio 45267-0558, USA. solomkjs@uc.edu
Abstract:
Ventilator-associated pneumonia has attracted considerable interest as a subject of clinical efficacy assessment research. This article summarizes recommendations made by the United States Public Health Service Panel on Cost-Effectiveness in Health and Medicine and by a panel convened by the American Thoracic Society to address economic analyses in critical care. The following recommendations are made for the performance of cost-efficacy studies in ventilator-associated pneumonia. For mortality-based studies, only data from prospective and blinded randomized trials are suitable for analysis. For cost-minimization studies, observational studies may be useful but should use rigorous matching schemes. Estimates for the quality of life of patients surviving an episode of ventilator-associated pneumonia should be based on the disease that required mechanical ventilation or compared to data available for survivors of the respiratory distress syndrome, whichever diagnosis provides a lessened quality of life. Within an individual intensive care unit the greatest cost savings come from constructing a cohesive and unified approach to many issues seen in the unit.
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