Cost-effectiveness issues in ventilator-associated pneumonia.
Ventilator-associated pneumonia has attracted considerable interest as a subject of clinical efficacy assessment research. This article summarizes recommendations made by the United States Public Health Service Panel on Cost-Effectiveness in Health and Medicine and by a panel convened by the American Thoracic Society to address economic analyses in critical care. The following recommendations are made for the performance of cost-efficacy studies in ventilator-associated pneumonia. For mortality-based studies, only data from prospective and blinded randomized trials are suitable for analysis. For cost-minimization studies, observational studies may be useful but should use rigorous matching schemes. Estimates for the quality of life of patients surviving an episode of ventilator-associated pneumonia should be based on the disease that required mechanical ventilation or compared to data available for survivors of the respiratory distress syndrome, whichever diagnosis provides a lessened quality of life. Within an individual intensive care unit the greatest cost savings come from constructing a cohesive and unified approach to many issues seen in the unit.
Division of Trauma and Critical Care, University of Cincinnati Medical Center, PO Box 670558, 231 Albert Sabin Way, Cincinnati, Ohio 45267-0558, USA. solomkjs@uc.edu
Joseph S
JS
Solomkin
D002985:Clinical Protocols; D003362:Cost-Benefit Analysis / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000191:economics* / Q000209:etiology; D019057:Quality-Adjusted Life Years; D014481:United States; D012122:Ventilators, Mechanical / Q000009:adverse effects*