Impact of mechanical ventilation on the daily costs of ICU care: a systematic review and meta regression

Epidemiol Infect. 2019 Dec 5:147:e314. doi: 10.1017/S0950268819001900.

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.

Keywords: Added costs; ICU costs; mechanical ventilation; review; ventilator-associated pneumonia.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Critical Care / economics*
  • Critical Care / methods
  • France
  • Germany
  • Hospital Costs / statistics & numerical data*
  • Humans
  • Intensive Care Units / economics*
  • Middle Aged
  • Respiration, Artificial / economics*
  • Young Adult