Tuberc Respir Dis.  2019 Apr;82(2):166-172. 10.4046/trd.2018.0065.

Association between Medical Costs and the ProVent Model in Patients Requiring Prolonged Mechanical Ventilation

Affiliations
  • 1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea. jubilate@pusan.ac.kr
  • 2Department of Rehabilitation Medicine, Pusan National University School of Medicine, Busan, Korea.

Abstract

BACKGROUND
The purpose of this study was to determine whether components of the ProVent model can predict the high medical costs in Korean patients requiring at least 21 days of mechanical ventilation (prolonged mechanical ventilation [PMV]).
METHODS
Retrospective data from 302 patients (61.6% male; median age, 63.0 years) who had received PMV in the past 5 years were analyzed. To determine the relationship between medical cost per patient and components of the ProVent model, we collected the following data on day 21 of mechanical ventilation (MV): age, blood platelet count, requirement for hemodialysis, and requirement for vasopressors.
RESULTS
The mortality rate in the intensive care unit (ICU) was 31.5%. The average medical costs per patient during ICU and total hospital (ICU and general ward) stay were 35,105 and 41,110 US dollars (USD), respectively. The following components of the ProVent model were associated with higher medical costs during ICU stay: age <50 years (average 42,731 USD vs. 33,710 USD, p=0.001), thrombocytopenia on day 21 of MV (36,237 USD vs. 34,783 USD, p=0.009), and requirement for hemodialysis on day 21 of MV (57,864 USD vs. 33,509 USD, p<0.001). As the number of these three components increased, a positive correlation was found betweeen medical costs and ICU stay based on the Pearson's correlation coefficient (γ) (γ=0.367, p<0.001).
CONCLUSION
The ProVent model can be used to predict high medical costs in PMV patients during ICU stay. The highest medical costs were for patients who required hemodialysis on day 21 of MV.

Keyword

Costs; Mechanical Ventilation; Intensive Care Units

MeSH Terms

Humans
Intensive Care Units
Male
Mortality
Platelet Count
Renal Dialysis
Respiration, Artificial*
Retrospective Studies
Thrombocytopenia
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