An Economic Analysis of Extracorporeal Membrane Oxygenation

Abstract

Financial considerations, in concert with clinical effec tiveness, are of increasing importance in the assessment of technological innovations. One such innovation, ex tracorporeal membrane oxygenation (ECMO), is now in use at over twenty centers nationwide to treat new borns with severe, acute lung disease. Use of ECMO therapy for one year at Children's Hospital National Medical Center, Washington, DC, in a population of pa tients with persistent pulmonary hypertension of the newborn (PPHN) is reported, comparing outcome and financial considerations with a similar group of infants treated conventionally prior to ECMO. A historical con trol group of infants with severe PPHN showed that before ECMO was available the survival rate in this criti cally ill population was only 21%. With ECMO, infants with the same clinical characteristics have an 80% chance of survival. Analysis of hospital and physician charges for these two groups (pre-ECMO and ECMO) reveals that ECMO therapy is about 2% less expensive than conventional treatment. When only survivors in each group are compared, ECMO is 43% less costly. These differences are attributable to reductions in aver age length of hospital stay with ECMO therapy, and they are conservative in that they do not take into considera tion the marked economic advantage to society of avert ing unnecessary deaths.