Cost comparison of mechanically ventilated patients across the age span

Area of Science:

• Critical Care Medicine
• Health Economics
• Neonatology

Background:

• Mechanical ventilation is a critical intervention for critically ill patients across all age groups.
• Understanding the associated hospital costs is essential for resource allocation and healthcare policy.
• Previous studies have not comprehensively compared costs across the full spectrum of ventilated patients, from preterm infants to adults.

Purpose of the Study:

• To compare the utilization of mechanical ventilation and associated hospital costs.
• To analyze these costs across all age groups, from preterm neonates to adult patients.
• To identify disparities in resource allocation and cost burden within a national inpatient sample.

Main Methods:

• Secondary analysis of the 2009 Agency for Healthcare Research and Quality National Inpatient Sample (NIS).
• Inclusion of all patients who received mechanical ventilation, spanning all ages.
• Statistical comparison of hospital costs based on survival status and age demographics.

Main Results:

• Over 1.1 million patients (2.8%) received mechanical ventilation.
• Surviving infants born at ⩽32 weeks' gestation incurred the highest median costs ($51,000–$209,000), significantly more than older patients ($17,000–$25,000).
• Non-surviving patients generally had lower median costs ($27,000–$39,000), with exceptions for extremely premature newborns (<24 weeks, $10,000) and elderly adults (91+ years, $14,000).
• Newborns consumed a disproportionate share of hospital costs relative to their volume.

Conclusions:

• Intensive care unit resources are not primarily allocated to non-surviving patients, even at the extremes of age.
• Focusing on improving outcomes and reducing costs for all infants, not solely the most premature, is crucial from a perinatal perspective.
• Further research into cost-effectiveness and targeted interventions for high-cost patient populations is warranted.