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Main Title: Does adherence to a quality indicator regarding early weaning from invasive ventilation improve economic outcome? A single-centre retrospective study
Author(s): Zuber, Alexander
Kumpf, Oliver
Spies, Claudia
Höft, Moritz
Deffland, Marc
Ahlborn, Robert
Kruppa, Jochen
Jochem, Roland
Balzer, Felix
Type: Article
Abstract: ObjectivesTo measure and assess the economic impact of adherence to a single quality indicator (QI) regarding weaning from invasive ventilation.DesignRetrospective observational single-centre study, based on electronic medical and administrative records.SettingIntensive care unit (ICU) of a German university hospital, reference centre for acute respiratory distress syndrome.ParticipantsRecords of 3063 consecutive mechanically ventilated patients admitted to the ICU between 2012 and 2017 were extracted, of whom 583 were eligible adults for further analysis. Patients’ weaning protocols were evaluated for daily adherence to quality standards until ICU discharge. Patients with <65% compliance were assigned to the low adherence group (LAG), patients with ≥65% to the high adherence group (HAG).Primary and secondary outcome measuresEconomic healthcare costs, clinical outcomes and patients’ characteristics.ResultsThe LAG consisted of 378 patients with a median negative economic results of −€3969, HAG of 205 (−€1030), respectively (p<0.001). Median duration of ventilation was 476 (248; 769) hours in the LAG and 389 (247; 608) hours in the HAG (p<0.001). Length of stay (LOS) in the LAG on ICU was 21 (12; 35) days and 16 (11; 25) days in the HAG (p<0.001). LOS in the hospital was 36 (22; 61) days in the LAG, and within the HAG, respectively, 26 (18; 48) days (p=0.001).ConclusionsHigh adherence to this single QI is associated with better clinical outcome and improved economic returns. Therefore, the results support the adherence to QI. However, the examined QI does not influence economic outcome as the decisive factor.
Subject(s): intensive and critical care
quality in health care
health economics
Issue Date: 6-Jan-2022
Date Available: 12-Jan-2022
Language Code: en
DDC Class: 610 Medizin und Gesundheit
Journal Title: BMJ Open
Publisher: British Medical Journal Publishing Group
Volume: 12
Issue: 1
Article Number: e045327
Publisher DOI: 10.1136/bmjopen-2020-045327
EISSN: 2044-6055
TU Affiliation(s): Fak. 5 Verkehrs- und Maschinensysteme » Inst. Werkzeugmaschinen und Fabrikbetrieb » FG Qualitätswissenschaft
Appears in Collections:Technische Universität Berlin » DeepGreen Deposits

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