open access

Vol 51, No 1 (2019)
Original and clinical articles
Published online: 2019-03-06
Submitted: 2017-11-19
Accepted: 2019-01-24
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Cost-effectiveness of home mechanical ventilation in children living in a developing country

Seyed Abbas Hassani, Safoura Navaei, Rohola Shirzadi, Hosein Rafiemanesh, Farzad Masiha, Majid Keivanfar, Leili Tahernia, Babak Moazzami, Gholamreza Azizi, Mohammad Aghaali, Mohammadreza Modaresi
DOI: 10.5603/AIT.a2019.0006
·
Anaesthesiol Intensive Ther 2019;51(1):35-40.

open access

Vol 51, No 1 (2019)
Original and clinical articles
Published online: 2019-03-06
Submitted: 2017-11-19
Accepted: 2019-01-24

Abstract

Background: Home mechanical ventilation is a promising option for children requiring long-term mechanical-assisted ventilation, while data on cost-effectiveness of this approach is limited. Aims: To investigate the cost-effectiveness of home mechanical ventilation in children requiring long-term mechanical-assisted ventilation. Methods: A retrospective cohort was conducted on 67 children (32 girls, 47.7%) requiring mechanical-assisted ventilation. Underlying diseases of children were congenital airway malformations in 24, cystic fibrosis in 4, severe laryngomalacia in 16, poly neuropathy syndrome in 6, mitochondrial myopathy in 5, hypoxic ischemic encephalopathy in 6, and cerebral palsy in 2. Children were admitted in pediatric intensive care units (ICU) for 2 weeks. After discharge, they were on home mechanical ventilation and were followed for 1 year. Data on daily costs of admission at ICU, rehospitalizations, weaning, educational performance and muscle strength were gathered. Results: Mean age of children at time of initiation of mechanical-assisted ventilation was 5.8 years (ranged from 2 months to 15 years). Mean number of re-hospitalizations was 3.4_4.9 times with mean duration of 9.44_2.53 days. Of children on mechanical ventilation, 1 attended school, 2 were weaned, and 21 experienced improvement in muscle strength. No fatal or serious complications were observed while children were on home mechanical ventilation. Mean costs of daily ICU admission was 912_1028 $, while the mean daily cost of home mechanical ventilation was 60.86_4.95 $ (p < 0.001). Conclusions: Home mechanical ventilation is more cost-effective compared to ICU admission for only mechanical-assisted ventilation. < p > < /p >

Abstract

Background: Home mechanical ventilation is a promising option for children requiring long-term mechanical-assisted ventilation, while data on cost-effectiveness of this approach is limited. Aims: To investigate the cost-effectiveness of home mechanical ventilation in children requiring long-term mechanical-assisted ventilation. Methods: A retrospective cohort was conducted on 67 children (32 girls, 47.7%) requiring mechanical-assisted ventilation. Underlying diseases of children were congenital airway malformations in 24, cystic fibrosis in 4, severe laryngomalacia in 16, poly neuropathy syndrome in 6, mitochondrial myopathy in 5, hypoxic ischemic encephalopathy in 6, and cerebral palsy in 2. Children were admitted in pediatric intensive care units (ICU) for 2 weeks. After discharge, they were on home mechanical ventilation and were followed for 1 year. Data on daily costs of admission at ICU, rehospitalizations, weaning, educational performance and muscle strength were gathered. Results: Mean age of children at time of initiation of mechanical-assisted ventilation was 5.8 years (ranged from 2 months to 15 years). Mean number of re-hospitalizations was 3.4_4.9 times with mean duration of 9.44_2.53 days. Of children on mechanical ventilation, 1 attended school, 2 were weaned, and 21 experienced improvement in muscle strength. No fatal or serious complications were observed while children were on home mechanical ventilation. Mean costs of daily ICU admission was 912_1028 $, while the mean daily cost of home mechanical ventilation was 60.86_4.95 $ (p < 0.001). Conclusions: Home mechanical ventilation is more cost-effective compared to ICU admission for only mechanical-assisted ventilation. < p > < /p >
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Keywords

mechanical ventilation, home; costs; children

About this article
Title

Cost-effectiveness of home mechanical ventilation in children living in a developing country

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 51, No 1 (2019)

Pages

35-40

Published online

2019-03-06

DOI

10.5603/AIT.a2019.0006

Bibliographic record

Anaesthesiol Intensive Ther 2019;51(1):35-40.

Keywords

mechanical ventilation
home
costs
children

Authors

Seyed Abbas Hassani
Safoura Navaei
Rohola Shirzadi
Hosein Rafiemanesh
Farzad Masiha
Majid Keivanfar
Leili Tahernia
Babak Moazzami
Gholamreza Azizi
Mohammad Aghaali
Mohammadreza Modaresi

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