Does adherence to a quality indicator regarding early weaning from invasive ventilation improve economic outcome? A single-centre retrospective study

dc.contributor.authorZuber, Alexander
dc.contributor.authorKumpf, Oliver
dc.contributor.authorSpies, Claudia
dc.contributor.authorHöft, Moritz
dc.contributor.authorDeffland, Marc
dc.contributor.authorAhlborn, Robert
dc.contributor.authorKruppa, Jochen
dc.contributor.authorJochem, Roland
dc.contributor.authorBalzer, Felix
dc.date.accessioned2022-01-12T15:22:39Z
dc.date.available2022-01-12T15:22:39Z
dc.date.issued2022-01-06
dc.date.updated2022-01-10T01:51:49Z
dc.description.abstractObjectivesTo 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.en
dc.identifier.eissn2044-6055
dc.identifier.pmid34992097en
dc.identifier.urihttps://depositonce.tu-berlin.de/handle/11303/16117
dc.identifier.urihttp://dx.doi.org/10.14279/depositonce-14891
dc.language.isoenen
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/en
dc.subject.ddc610 Medizin und Gesundheitde
dc.subject.otherintensive and critical careen
dc.subject.otherquality in health careen
dc.subject.otherhealth economicsen
dc.titleDoes adherence to a quality indicator regarding early weaning from invasive ventilation improve economic outcome? A single-centre retrospective studyen
dc.typeArticleen
dc.type.versionpublishedVersionen
dcterms.bibliographicCitation.articlenumbere045327en
dcterms.bibliographicCitation.doi10.1136/bmjopen-2020-045327en
dcterms.bibliographicCitation.issue1en
dcterms.bibliographicCitation.journaltitleBMJ Openen
dcterms.bibliographicCitation.originalpublishernameBritish Medical Journal Publishing Groupen
dcterms.bibliographicCitation.originalpublisherplaceLondonen
dcterms.bibliographicCitation.volume12en
tub.accessrights.dnbfreeen
tub.affiliationFak. 5 Verkehrs- und Maschinensysteme>Inst. Werkzeugmaschinen und Fabrikbetrieb>FG Qualitätswissenschaftde
tub.affiliation.facultyFak. 5 Verkehrs- und Maschinensystemede
tub.affiliation.groupFG Qualitätswissenschaftde
tub.affiliation.instituteInst. Werkzeugmaschinen und Fabrikbetriebde
tub.publisher.universityorinstitutionTechnische Universität Berlinen
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