The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts

THE COST OF MECHANICAL VENTILATION: REDUCTIONS DUE TO USE OF A COMMERCIAL ENDOTRACHEAL TUBE HOLDER.

Michael J. Hewitt1, Melissa Martinson2, Noel Martinson3; 1Respiratory Care Services, St. Joseph's Hospitals, Tampa, FL; 2Technomics Research, Minneapolis, MN; 3Acclaim Data Analytics, LLC, Minneapolis, MN

Background: Patients on mechanical ventilation are at high risk of complications, in particular unplanned extubations, lip pressure ulcers and ventilator-associated pneumonia (VAP). Hospitals recognize this and, to mitigate potential risk, can use a commercially-available endotracheal tube holder. A Medicare claims analysis was used to compare ventilated patients in hospitals using the Anchor Fast oral endotracheal tube fastener to matched hospitals that did not, to assess for differences in cost of care in these patients. Methods: Medicare 2008 standard analytic files were used. 543 hospitals known to have purchased the Anchor Fast oral endotracheal tube fastener in 2008 were identified and matched to an equal number of hospitals that did not. In-patient stays with mechanical ventilation longer than one day were identified by ICD-9 codes, and hospital costs for each were estimated by multiplying the hospital's Medicare cost-to-charge ratio by the hospital's charges. Length of stay (LOS) and frequency of complications (VAP, reintubation, chest x-rays, pressure ulcers and lacerations) were tallied. LOS and LN(cost) were analyzed using Tobit (left censored) and multiple linear regression, respectively; regressors included patient characteristics. Results: 97,360 patients, as described, were identified. The average cost of ventilated patients in hospitals not using the Anchor Fast oral endotracheal tube fastener was $30,643 while the average cost in hospitals using the AnchorFast oral endotracheal tube fastener was $30,510, a reduction of $132 (p=0.032) per patient. The average LOS in hospitals using the Anchor Fastoral endotracheal tube fastener was 20.1 days versus 20.3 days in hospitals not using the product, a difference of 0.2 days (p=0.007). Conclusions: The use of the Anchor Fast oral endotracheal tube fastener may be associated with a statistically significant and financially important reduction in average costs for the patients studied. The average savings of $132 per patient includes the purchase of the device. Sponsored Research - None