FROM ANNALS OF THE AMERICAN THORACIC SOCIETY

Postadmission health care costs varied considerably by the duration of patients’ in-hospital mechanical ventilation, according to a study of Canadian administrative databases.

Critically ill patients in the province of Ontario who received mechanical ventilation for more than 21 days (n = 3,891) had a median health care cost of $42,784 (all costs are in Canadian dollars) in the year after their discharge, compared with $13,005 for patients who were ventilated for 21 or fewer days (n = 78,984), reported Andrea D. Hill, PhD, of Sunnybrook Health Sciences Centre, Toronto, and her associates (Ann Am Thorac Soc. 2017;14[3]:355-62).

The cost of the admission itself was $166,262 for those who received more than 21 days of ventilation, versus $32,994 for those ventilated for 21 or fewer days, but the total heath care cost for the year before the index admission was slightly higher for those who had the shorter duration of ventilation ($9,519 vs. $8,990), the investigators said.

Dr. Hill and her associates also found that patients with longer-term ventilation were less likely to be discharged home (15% vs. 57%) and more likely to be readmitted after 6 months (36% vs. 29%) or 1 year (47% vs. 38%), but were not more likely to have an emergency department visit after 6 months (46% vs. 45%).

All patients received ventilation from April 1, 2002, to March 31, 2013. The population-based cohort study used four databases: the Canadian Institute of Health Information Discharge Abstract Database, the Ontario Health Insurance Plan database, the National Ambulatory Care Reporting System database, and the Ontario Registered Persons Database.

rfranki@frontlinemedcom.com

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