Shifting Care of Chronic Ventilator-Dependent Patients from the Intensive Care Unit to the Nursing Home

Lindsay, Mark E.; Bijwadia, Jagdeep; Schauer, Whitney; Rozich, John D.

doi:10.1016/s1549-3741(04)30028-6

Cited by 17 publications

(11 citation statements)

References 11 publications

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“…Lindsay and colleagues reported their outcomes with PMV patients referred to a stand-alone nursing home ventilator unit. 42 Sixty-eight (67%) of 102 patients were successfully weaned during a 6-year period. NIV facilitated successful weaning in 27 (26%) of 102 patients.…”

Section: Skilled Nursing Facilitiesmentioning

confidence: 99%

Current Venues of Care and Related Costs for the Chronically Critically Ill

Donahoe

2012

Respir Care

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The chronically critically ill (CCI) patient population is characterized by a prolonged need for high cost medical interventions, a high 1-year mortality rate, and a very high demand for post acute care services. The best characterized CCI patient population is patients on prolonged mechanical ventilation (PMV). This review will focus on the current knowledge of costs and care venues for the care of this patient population. The PMV population suffers from a prolonged length of acute care hospital stay, median hospital costs 3-4 times the cost of short-term ventilator patients, frequent care venue changes during the course of illness, a small likelihood of discharge to the home environment, yet a hospital mortality that does not differ significantly from the short-term ventilated patient group. The PMV population is projected to double in size by the year 2020. Given the dramatic comparative acute care cost burden of PMV patients, the societal implications for managing both the care burden and the costs of care are staggering. Strategies to improve the efficiency in healthcare for this patient population will be essential. Limitations to the existing care models in the United States will be identified with a focus on our current research deficiencies, which limit healthcare providers and administrators in providing patient focused care for this patient population.

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Section: Skilled Nursing Facilitiesmentioning

confidence: 99%

Current Venues of Care and Related Costs for the Chronically Critically Ill

Donahoe

2012

Respir Care

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“…One such facility is the regional ventilator weaning center, which has received a lot of research attention for several years in the US, UK, and other countries [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. Many studies have reported that transferring MV-dependent patients from ICUs to regional ventilator weaning centers decreases costs [8,17,18].…”

Section: Introductionmentioning

confidence: 99%

The soaring mechanic ventilator utilization under a universal health insurance in Taiwan

2008

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“…Nonetheless, the profit may appear a least important objective for a hospital in which costs of beds in a critical care area are usually covered by the overall incomes covering the other health care activities. Indeed, previous reports from Europe [16] and US [3,[17][18][19] have shown significantly high costs and use of human resources in these critical care (although step-down) units. The problem of costs is very difficult to approach and many different items are crucial to quantify and therefore to subsequently assess the amount of reimbursement necessary.…”

Section: Discussionmentioning

confidence: 99%

Activity and analysis of costs in a dedicated weaning centre

Clini

Siddu²,

Trianni³

et al. 2016

Monaldi Arch Chest Dis

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Aim. To analyse the diagnosis-related characteristics and the costs of treating patients with difficult/prolonged weaning from mechanical ventilation we have undertaken a retrospective observational study. Methods. The study has considered all the patients admitted to our weaning unit of a regional Rehabilitation department during 3 consecutive periods since the opening date. Characteristics of the admitted patients and the DRG-related cares delivered have been recorded. A cost analysis has been obtained over time. Results. The number of beds allocated to this unit (from 4 in the 1st period to 6 in the 2nd and 3rd periods) and the number of patients cared for (from 32 to 43 and to 65, respectively) increased over time. In particular, the COPD to non-COPD patient ratio (from 2.2 to 1.3 and to 1.0) and the DRG/patient weight (from 3.0±0.3 to 3.1±0.2 and to 3.3±0.2 point) changed significantly (p<0.05). The daily reimbursement per patient from the public health care system only slightly increased, whereas the operating margin (reimbursement less costs) per patient significantly improved (from -304, to +17 and +55 €/pt/day, respectively, p<0.05) due to a gradual restriction in the variable costs. Length of stay, mortality rate and weaning rate did not change over time. Conclusion. The weaning centre is a hospital area where economic burdens should be carefully evaluated. Given the actual reimbursement received on a national level for these patients, variable costs might be better spread, thus optimising the burdens without losing out on clinical outcomes.

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Shifting Care of Chronic Ventilator-Dependent Patients from the Intensive Care Unit to the Nursing Home

Cited by 17 publications

References 11 publications

Current Venues of Care and Related Costs for the Chronically Critically Ill

Current Venues of Care and Related Costs for the Chronically Critically Ill

The soaring mechanic ventilator utilization under a universal health insurance in Taiwan

Activity and analysis of costs in a dedicated weaning centre

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