Abstract
The impact of mechanical ventilation on the daily costs of intensive care unit (ICU) care is largely unknown. We thus conducted a systematic search for studies measuring the daily costs of ICU stays for general populations of adults (age ≥18 years) and the added costs of mechanical ventilation. The relative increase in the daily costs was estimated using random effects meta regression. The results of the analyses were applied to a recent study calculating the excess length-of-stay associated with ICU-acquired (ventilator-associated) pneumonia, a major complication of mechanical ventilation. The search identified five eligible studies including a total of 54 766 patients and ~238 037 patient days in the ICU. Overall, mechanical ventilation was associated with a 25.8% (95% CI 4.7%-51.2%) increase in the daily costs of ICU care. A combination of these estimates with standardised unit costs results in approximate daily costs of a single ventilated ICU day of €1654 and €1580 in France and Germany, respectively. Mechanical ventilation is a major driver of ICU costs and should be taken into account when measuring the financial burden of adverse events in ICU settings.
Highlights
Intensive care consumes a large proportion of healthcare resources
For patients under mechanical ventilation, one of the infections commonly acquired in the hospital is ventilator-associated pneumonia (VAP)
The major aim of this review is to determine the relative impact of mechanical ventilation on the daily costs of intensive care unit (ICU) care
Summary
Intensive care consumes a large proportion of healthcare resources. Days in intensive care are substantially more costly than general ward days in hospitals due to increased resource utilization and labour intensity. One major driver of these costs is mechanical ventilation. Adverse events occurring during hospitalization add a substantial further burden to the healthcare system. The most prevalent hospital-onset conditions are hospital-acquired infections, which absorb substantial resources in hospitals and often require costly treatment [1]. For patients under mechanical ventilation, one of the infections commonly acquired in the hospital is ventilator-associated pneumonia (VAP)
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