Economic feasibility of a novel tool to assist extubation decision-making: an early health economic modeling.

Autor:	Zheng K; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada., Kumar S; Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada., Sarti AJ; Department of Critical Care, The Ottawa Hospital, Ottawa, ON, Canada., Herry CL; Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada., Seely AJE; Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.; Department of Critical Care, The Ottawa Hospital, Ottawa, ON, Canada.; Division of Thoracic Surgery, The Ottawa Hospital, Ottawa, ON, Canada., Thavorn K; Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Jazyk:	angličtina
Zdroj:	International journal of technology assessment in health care [Int J Technol Assess Health Care] 2022 Jul 11; Vol. 38 (1), pp. e66. Date of Electronic Publication: 2022 Jul 11.
DOI:	10.1017/S0266462322000472
Abstrakt:	Objectives: To estimate the minimum percent change in failed extubation to make a tool designed to reduce extubation failure (Extubation Advisor [EA]) economically viable. Methods: We conducted an early return on investment (ROI) analysis using data from intubated intensive care unit (ICU) patients at a large Canadian tertiary care hospital. We obtained input parameters from the hospital database and published literature. We ran generalized linear models to estimate the attributable length of stay, total hospital cost, and time to subsequent extubation attempt following failure. We developed a Markov model to estimate the expected ROI and performed probabilistic sensitivity analyses to assess the robustness of findings. Costs were presented in 2020 Canadian dollars (C$). Results: The model estimated a 1 percent reduction in failed extubation could save the hospital C$289 per intubated patient (95 percent CI: 197, 459). A large center seeing 2,500 intubated ICU patients per year could save C$723,124/year/percent reduction in failed extubation. At the current annual price of C$164,221, the EA tool must reduce extubation failure by at least 0.24 percent (95 percent CI: .14, .41) to make the tool cost-effective at our site. Conclusions: Clinical decision-support tools like the EA may play an important role in reducing healthcare costs by reducing the rate of extubation failure, a costly event in the ICU.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu