title: Clinical and economic outcome of patients undergoing tracheostomy for prolonged mechanical ventilation in New York state during 1993: analysis of 6,353 cases under diagnosis-related group 483.
abstract: OBJECTIVE
  To examine and describe the relation between age and disposition in patients undergoing tracheostomy.
  
  
  METHODS
  Retrospective analysis of a statewide database.
  
  
  METHODS
  All acute care hospitals in New York state.
  
  
  METHODS
  All patients (n = 6,353) > or = 18 yrs of age who were discharged from the hospital during 1993 with a final diagnosis-related groups code of 483.
  
  
  METHODS
  None.
  
  
  RESULTS
  The final disposition, according to six disposition codes (other acute care facility, residential healthcare facility, other healthcare facility, home, home healthcare services, and death) was examined for the entire population. Cost per case was assumed to equal the average statewide Medicaid rate. An inverse relation between survival rate and age was observed, which resulted in an age-related increased cost per survivor. Also, survivors in older age groups had an increased rate of discharge to residential healthcare facilities. There was a negative, albeit less marked, effect of older age on the rates of survivors discharged to home and to other healthcare facilities.
  
  
  CONCLUSIONS
  Care of patients who undergo tracheostomy for prolonged mechanical ventilation is expensive. The older the patient, the less satisfactory the outcome from an economic, clinical, and possibly social perspective.
authors.affiliation: Department of Anesthesiology, State University of New York at Buffalo, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Kurek
authors.forename: I L
authors.initials: IL
authors.lastname: Cohen
authors.forename: J
authors.initials: J
authors.lastname: Lambrinos
authors.forename: K
authors.initials: K
authors.lastname: Minatoya
authors.forename: F V
authors.initials: FV
authors.lastname: Booth
authors.forename: D B
authors.initials: DB
authors.lastname: Chalfin
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003953:Diagnosis-Related Groups; D004470:Economics, Medical; D006801:Humans; D007349:Insurance, Health, Reimbursement; D008875:Middle Aged; D009518:New York; D012189:Retrospective Studies; D015996:Survival Rate; D014139:Tracheostomy; D012122:Ventilators, Mechanical