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

  • Objectives: To measure and assess the economic impact of adherence to a single quality indicator (QI) regarding weaning from invasive ventilation. Design: Retrospective observational single-centre study, based on electronic medical and administrative records. Setting: Intensive care unit (ICU) of a German university hospital, reference centre for acute respiratory distress syndrome. Participants: Records 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 measures: Economic healthcare costs, clinical outcomes and patients’ characteristics. Results: The 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). Conclusions: High 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.

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Author:Alexander ZuberORCiD, Oliver KumpfORCiD, Claudia SpiesORCiD, Moritz HöftORCiD, Marc DefflandORCiD, Robert Ahlborn, Jochen Kruppa-ScheetzORCiD, Roland JochemORCiD, Felix BalzerORCiD
Title (English):Does adherence to a quality indicator regarding early weaning from invasive ventilation improve economic outcome? : A single-centre retrospective study
URN:urn:nbn:de:bsz:959-opus-58913
DOI:https://doi.org/10.1136/bmjopen-2020-045327
ISSN:2044-6055
Parent Title (English):BMJ Open
Document Type:Article
Language:English
Year of Completion:2022
Release Date:2024/04/23
Volume:12
Issue:1
Article Number:e045327
Page Number:9
Faculties:Fakultät AuL
DDC classes:600 Technik, Medizin, angewandte Wissenschaften / 610 Medizin, Gesundheit
Review Status:Veröffentlichte Fassung/Verlagsversion
Licence (German):License LogoCreative Commons - CC BY-NC - Namensnennung - Nicht kommerziell 4.0 International