The Science Journal of the American Association for Respiratory Care

2003 OPEN FORUM Abstracts

INHALED NITRIC COST IN A NEONATAL AND PEDIATRIC ICU POPULATION: IS YOUR BUDGET READY FOR IT?

Rachael Caleca, RRT, Paula Wood, RRT, Kenneth P. Bandy, BBA, RRT, Ronald E. Dechert, Dr. PH, RRT, Department of Critical Care Support Services, University Of Michigan Medical Center, Ann Arbor, MI

BACKGROUND. Previous researchers, including two large, randomized controlled trials, have demonstrated inhaled nitric oxide (iNO) therapy as being efficacious in reducing pulmonary hypertension and improving oxygenation in neonatal and pediatric ICU patient populations. To date, no studies have examined the institutional cost of this new therapy. The purpose of this study was to examine the institutional cost associated with the administration of iNO at a large, tertiary care center.

METHODS
. The institutional cost of iNO was analyzed for all neonatal and pediatric patients who received this therapy at our institution over the period January 1, 2001-December 31, 2002. The institutional cost were those expenses submitted by the provider (INOTherapeutics, Inc), which were based upon the contractual payment agreement. A total of 199 patients received iNO during the two-year period.

RESULTS.
The demographic, utilization and cost analyses for all patients are presented in Table 1. The information is stratified by user group, calendar year and aggregated for the entire patient cohort.  

Table 1: Demographic, utilization and cost of iNO  

  Neonatal Congenital Heart Med-Surg Aggregate
  2001 2002 2001 2002 2001 2002 2001 2002
Patients 43 42 49 40 13 12 105 94
Patient use (hrs) 106 41 61 26 62 14 80 31
Total use (hrs) 4566 1705 2992 1051 805 172 8363 2930
Patient cost ($) 7214 4178 4146 2113 4578 1796 5456 2995
Total cost (Thousand $) $310 $175 $203 $85 $60 $22 $573 $282


 
CONCLUSIONS. Inhaled nitric oxide represents a significant cost to our institution. To date, no reimbursement from third-party payers has been realized. As such, further cost-benefit analysis and efforts to control utilization are warranted. Our efforts to control these cost (through protocolized utilization) have successfully decreased cost and duration per case.

 

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