The Science Journal of the American Association for Respiratory Care

2005 OPEN FORUM Abstracts

RETURN ON INVESTMENT ANALYSIS OF COST SAV`INGS FROM REDUCED VENTILATOR DAYS USING VAPOTHERM TO DELIVER HIGH FLOW THERAPY

Peter Boyd BS, JD/MBA (c), University of Virginia Law School, Darden School of Business, Charlottesville, Virginia

INTRODUCTION: High flow therapy (HFT) using Vapotherm 2000i has been shown to reduce the need to ventilate patients with certain ailments1. The average ventilated person stays on a respirator for 4.7 days, SD 7 days2. There are increased costs associated with ventilation, and intubation exposes the patient to the possibility of contracting ventilator-associated pneumonia (VAP). Published reports of VAP rates range from 8-28%3, and Rello et. al. measured a 9.3% rate among the 9080 patients in their study2. Warren et. al. calculated the attributable cost of VAP to be $11,8974. Therefore, treatment which reduces the need to ventilate patients has the potential to significantly reduce hospital costs.

METHODS: To quantify the potential cost savings a financial model was created using Crystal BallĀ® software to examine the risk profile for a 250 bed hospital investing $94,325 to purchase 25 Vapotherm 2000i units. It was assumed that at least 1000 patients would be ventilated in a 250 bed hospital over the course of a year and the increased costs associated with ventilation were $500 per day. A triangular distribution was used to calculate the percentage of patients who would not need to be intubated if they used Vapotherm with a minimum of 0%, a most likely of 10%, and a maximum of 20% (0%, 10%, 20%). The ventilation length was 4.7 days, SD 7 days. A triangular distribution was also used to calculate the percentage of ventilated patients who contracted VAP (8%, 9.7%, 28%) and the cost of contracting VAP was $11,897. Five-thousand trials were run using Crystal Ball with different percentages that fell in the ranges outlined above. Each trial was plotted to establish the risk profile associated with investing in 25 Vapotherm units.

RESULTS
: The expected time to payback the capital expenditure with a 10% Vapotherm success rate is less than five months and there is over a 90% chance that the machines will pay for themselves within a year. The expected monetary savings of purchasing 25 Vapotherm units after a year is $256,900 and the upside potential saving are over $1,094,943.

DISCUSSION
: Putting a patient on a respirator is an expensive procedure which increases the potential for nosocomial infection. The Vapotherm 2000i delivers non-invasive HFT that often prevents the need for a ventilator. This ROI model shows that the cost savings associated with using Vapotherm 2000i throughout the hospital as a precursor to ventilation allows the units to pay for themselves in less than five months.

CONCLUSION
: Investing in the Vapotherm 2000i can significantly reduce hospital costs and eliminate the possibility of transferring VAP. The significant savings associated with using Vapotherm will pay for the units in less than half a year.

1. Sarkisian-Donovan, J., et. al. High Flow Gas Therapy Via Nasa Cannuala for Repiratory Insufficiency. Respir Care 2004; 49: 1443

2. Rello J, Ollendorf DA, Oster G, et. al. Epidemiology and outcomes of ventilator-associated pneumonia in a large US database. Chest 2002; 122: 2115-2121

3. Shorr, A. F., Wunderink, R. G. Dollars and sense in the intensive care unit: The costs of ventilator-associated pneumonia. Crit Care Med 2003; 31: 1582-1583

4. Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care Med 2002; 165:867-903

Study Funded by Vapotherm

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