The Cost of ARDS: A Systematic Review.

Chest

Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Published: March 2022

AI Article Synopsis

  • ARDS (Acute Respiratory Distress Syndrome) is an inflammatory lung condition often requiring significant resources and resulting in high costs due to lengthy ICU stays.
  • The study systematically reviewed literature up to April 2021 to assess the costs associated with ARDS, analyzing 110 articles and ultimately extracting data from 22 studies involving nearly 50,000 patients.
  • The findings revealed that inpatient costs varied greatly, averaging between $8,476 and $547,974, with higher costs linked to American health systems, lower-quality publications, and trauma-related cases, while outpatient costs increased with readmission rates and prolonged follow-up periods.

Article Abstract

Background: ARDS is an inflammatory condition of the lungs and is a common condition in adult ICUs. The resources required and costs of care for patients with ARDS are significant because of the severity of the illness and extended ICU lengths of stay.

Research Question: What are the costs associated with ARDS?

Study Design And Methods: We systematically searched the literature through April 29, 2021, for articles relevant to ARDS and costs. MEDLINE, Embase, Central, and EconLit databases were searched, and articles that reported on cost data from an original publication in adult patients with ARDS were included. Two authors independently assessed articles for inclusion and extracted data elements related to costs, methodology, health care system type, economic perspective, and clinical data. Publication quality was assessed using a modified version of the Quality of Health Economic Studies Instrument.

Results: Four thousand six hundred sixty-three publications were found, of which 110 were included for full-text review (κ = 0.72). A total of 22 publications (49,483 patients) were suitable for data extraction. The publications represented a broad range of health care systems, economic perspectives, costing methodology, and time frames. Mean inpatient costs ranged from $8,476 (2021 US dollars [USD]) to $547,974 (2021 USD) and were highest in publications of lower quality and in American health systems and were associated with trauma cohorts. Outpatient costs were highest in publications with higher readmission rates, longer durations of follow-up, and in American health systems.

Interpretation: A wide range of costing data is available for ARDS. A comprehensive synthesis of this literature frames the reasons for this and allows estimates to reflect the context in which they were assessed. This information will be of value to researchers and administrators interested in the economics of caring for patients with ARDS.

Trial Registry: PROSPERO; No.: CRD42020192487 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=192487.

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Source
http://dx.doi.org/10.1016/j.chest.2021.08.057DOI Listing

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