Prolonged mechanical ventilation for respiratory failure: a cost-benefit analysis

Area of Science:

• Critical Care Medicine
• Health Economics

Background:

• Prolonged mechanical ventilation (PMV) is a critical intervention for physiologically unstable patients requiring intensive care.
• Respiratory failure stems from diverse causes, including pulmonary, post-operative, neuromuscular, cardiac, and gastrointestinal conditions.

Purpose of the Study:

• To retrospectively analyze the costs and benefits of prolonged mechanical ventilation (PMV).
• To determine the cost-benefit relationship of PMV based on patient characteristics and disease etiology.

Main Methods:

• Retrospective review of 137 consecutive patients requiring at least 48 hours of ventilator support.
• Analysis of hospitalization costs and long-term survival data.

Main Results:

• 36% of patients survived hospitalization; 28% were alive at 3 years post-PMV.
• Mean total hospital cost was $16,930 per patient (1976-1977).
• Cost-benefit averaged $1826 per year of extended life, with significant variation by disease (e.g., asthma vs. cardiac dysfunction) and age.

Conclusions:

• The cost-benefit ratio of PMV is heavily influenced by the primary disease process and patient age.
• Age and underlying condition are critical factors in assessing the economic impact of prolonged mechanical ventilation.