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Anaesthesiol Intensive Ther. 2019;51(1):35-40. doi: 10.5603/AIT.a2019.0006.

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

Author information

1
Pediatric Respiratory and Sleep Medicine Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic Of.
2
Students' Research Committee, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic Of.
3
Department of Pediatrics, Mazandaran University of Medical Sciences, Sari, Iran, Islamic Republic Of.
4
Department of Pediatric Pulmonology, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic Of.
5
Student Research Committee, Babol University of Medical Sciences, Babol, Iran, Islamic Republic Of.
6
Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran; and Department of Laboratory Medicine, Imam Hassan Mojtaba Hospital, Alborz University of Medical Sciences, Karaj, Iran, Islamic Republic Of.
7
Department of Epidemiology, Qom University of Medical Sciences, Qom, Iran, Islamic Republic Of.
8
Pediatric Respiratory and Sleep Medicine Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic Of. mr-modaresi@sina.tums.ac.ir.

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 >.

KEYWORDS:

children; costs; home; mechanical ventilation

PMID:
31280550
DOI:
10.5603/AIT.a2019.0006

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