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.
Solomkin
Joseph S
JS
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
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*