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Does adherence to a quality indicator regarding early weaning from invasive ventilation improve economic outcome? A single-centre retrospective study. | LitMetric

AI Article Synopsis

  • The study aimed to evaluate the economic impact of following a quality indicator (QI) for weaning patients off invasive ventilation in a German ICU.
  • It analyzed records of 583 patients, categorizing them into low adherence (LAG) and high adherence (HAG) groups based on their compliance with the weaning protocol.
  • Results showed that high adherence was linked to shorter ventilation time and hospital stays, as well as lower negative economic outcomes, supporting the importance of adhering to quality indicators in critical care.

Article Abstract

Objectives: To measure and assess the economic impact of adherence to a single quality indicator (QI) regarding weaning from invasive ventilation.

Design: Retrospective observational single-centre study, based on electronic medical and administrative records.

Setting: Intensive care unit (ICU) of a German university hospital, reference centre for acute respiratory distress syndrome.

Participants: Records of 3063 consecutive mechanically ventilated patients admitted to the ICU between 2012 and 2017 were extracted, of whom 583 were eligible adults for further analysis. Patients' weaning protocols were evaluated for daily adherence to quality standards until ICU discharge. Patients with <65% compliance were assigned to the low adherence group (LAG), patients with ≥65% to the high adherence group (HAG).

Primary And Secondary Outcome Measures: Economic healthcare costs, clinical outcomes and patients' characteristics.

Results: The LAG consisted of 378 patients with a median negative economic results of -€3969, HAG of 205 (-€1030), respectively (p<0.001). Median duration of ventilation was 476 (248; 769) hours in the LAG and 389 (247; 608) hours in the HAG (p<0.001). Length of stay (LOS) in the LAG on ICU was 21 (12; 35) days and 16 (11; 25) days in the HAG (p<0.001). LOS in the hospital was 36 (22; 61) days in the LAG, and within the HAG, respectively, 26 (18; 48) days (p=0.001).

Conclusions: High adherence to this single QI is associated with better clinical outcome and improved economic returns. Therefore, the results support the adherence to QI. However, the examined QI does not influence economic outcome as the decisive factor.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739420PMC
http://dx.doi.org/10.1136/bmjopen-2020-045327DOI Listing

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