Cost-Minimization Analysis of Non-Invasive and Invasive Mechanical Ventilation for De Novo Acute Hypoxemic Respiratory Failure in an Eastern European Setting
| Autor: | Rossen Petkov, T. Mihalova, Yo. Yamakova, B. Velev, Viktoria Ilieva |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Mechanical ventilation
pharmacoeconomy medicine.medical_specialty business.industry medicine.medical_treatment non-invasive ventilation De novo acute Non invasive General Medicine Hypoxemic respiratory failure mechanical ventilation Eastern european 03 medical and health sciences 0302 clinical medicine 030228 respiratory system invasive ventilation Cost-minimization analysis cost-minimization medicine Medicine 030211 gastroenterology & hepatology Intensive care medicine business health care economics and organizations |
| Zdroj: | Acta Medica Bulgarica, Vol 46, Iss 1, Pp 17-20 (2019) |
| ISSN: | 0324-1750 |
| Popis: | Introduction: In the light of constant pressure for minimizing healthcare costs we made a cost-minimization analysis comparing invasive mechanical ventilation (IMV) and non-invasive ventilation (NIV) as treatment for hypoxemic acute respiratory failure (ARF). Aim: The primary objective was to estimate the direct medical costs generated by a patient on IMV and NIV. A secondary objective was to identify which aspect of the treatment was most expensive. Material and Methods: This is a single center retrospective study including 36 patients on mechanical ventilation due to hypoxemic ARF, separated in two groups – NIV (n = 18) and IMV (n = 18). We calculated all direct medical costs in Euro and compared them statistically. Results: On admission the PaO2/FiO2 and SAPS II score were comparable in both groups. We observed a significant difference in the costs per patient for drug treatment (NIV: 616.07; IQR: 236.68, IMV:1456.18; IQR:1741.95, p = 0.005), consumables (NIV: 16.47; IQR: 21.44, IMV: 98.79; IQR: 81.52, p < 0.001) and diagnostic tests (NIV: 351; IQR: 183.88, IMV: 765.69; IQR: 851.43, p < 0.001). We also computed the costs per patient per day and there was a significant difference in the costs in all above listed categories. In both groups the highest costs were for drug treatment – around 61%. Conclusions: In the setting of hypoxemic ARF NIV reduces significantly the direct medical costs of treatment in comparison to IMV. The decreased costs in NIV are not associated with severity of disease according to the respiratory quotient and SAPS II score. |
| Databáze: | OpenAIRE |
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