Trend analysis of hospital resource utilization for prolonged mechanical ventilation patients in Taiwan: a population-based study.
BACKGROUND
The aging Taiwan population is expected to require vast medical resources, including prolonged mechanical ventilation (PMV). This study determined the trends in hospital resource utilization and associated factors in PMV patients in Taiwan.


METHODS
All patients who had received mechanical ventilation for > 21 days (International Classification of Diseases, 9th Revision, Clinical Modification codes 518.81-518.89) during 2004-2007 were recruited to the study. Administrative claims data obtained from the Bureau of National Health Insurance of Taiwan were analyzed.


RESULTS
The study analyzed 65,181 patients who had received PMV during 2004-2007. The number of PMVs per 100,000 persons was 94.30 in 2004, and it gradually decreased to 89.38 in 2007, which was a change rate of -5.22%. During the study period, stay significantly decreased, from 35.12 days to 31.61 days, whereas hospital treatment costs significantly increased, from $7,933.17 to $8,257.52 (P < .001). Considerably decreased stay and increased hospital treatment costs were significantly associated with age, number of comorbidities, hospital level, hospital volume, and patient referral source (P < .001).


CONCLUSIONS
These population-based data demonstrated a decrease in the prevalence of PMV, especially for older patients, and that stay decreased; however, hospital treatment costs increased. Moreover, healthcare providers and patients should recognize that attributes of both the patient and the hospital may affect hospital resource utilization. Additionally, these analytical results should be applicable to similar populations in other countries.
Department of Respiratory Therapy, E-Da Hospital, I-Shou University, Taiwan.
Tien-Chiung
TC
Hung
Yung-Fa
YF
Lai
Ching-Wan
CW
Tseng
Yong-Han
YH
Hong
Hon-Yi
HY
Shi
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006304:Health Status; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012121:Respiration, Artificial / Q000191:economics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013624:Taiwan; D013997:Time Factors