PIN21 - Cost Reduction Associated with Use of Subglottic Aspiration to Reduce Ventilator-Associated Pneumonia in Turkey

Abstract

Ventilator-associated pneumonia(VAP) is a serious complication risk for patients who require invasive mechanical ventilation(IMV). VAP is associated with longer intensive care unit and hospital stays, which may increase health care expenditures. VAP may occur in 8% of IMV patients. Subglottic aspiration (SA) may decrease VAP by up to 45% in IMV patients. The goal of this analysis is to calculate the potential cost reduction associated with SA use for VAP reduction in IMV patients in Turkey. A literature analysis was conducted in PubMed(2000-present) to determine the published cost of VAP in Turkey. Published costs were used for the conversion to Turkish Lira(TL). An annual inflation rate of 3% was applied to the cost data to project the estimated cost in 2013. The exchange rate for USD to TL was estimated at 1.8. A weighted average of the number of patients in each study was used to calculate the cost of treatment. The cost of SA to the Social Security Institution (SGK) was calculated as 33.94 TL, which includes the cost of the SA tube(TaperGuard EVAC; 25 TL) and the SA service reimbursement amount from the SGK of 8.94 TL. 8% and 45% were taken as the VAP rate and reduction with SA rate in IMV patients, respectively. The number of patients requiring IMV in a hospital was estimated at 1000 per year. The average inpatient costs of IMV patients with and without VAP were calculated to be 13.556 TL and 3.971 TL, respectively. The total VAP cost, based on 80 VAP cases in 1,000 IMV cases without SA, was calculated as 1.085.297 TL. A hospital using SA for all IMV cases is estimated to have VAP costs equal to 488.384 TL and SA costs of 33.940 TL for a total cost of 522.324 TL. Cost reduction from SA use was calculated as 562.973 TL. VAP increases health expenditures by 9.595 TL per patient. A hospital with 1,000 IMV patients per year that uses SA in all IMV patients may realize an estimated cost reduction of 562.973 TL associated with use of SA in IMV patients.