Outcome and costs of intensive care. A follow-up study on patients requiring prolonged mechanical ventilation

Abstract

This historically prospective study analysed hospital costs and long-term outcome in 249 consecutive patients who required intensive care including intermittent positive pressure ventilation (IPPV) for 48 h or more. The mean age of the patients was 46.7 years and the mean duration on IPPV was 9.1 days. Mortality in hospital was 43%, increasing to 54.6% five years after admission. The mean cost per patient treated was 22823 USA dollars (USD (1980)). The mean cost to yield one survivor was 40035 USD. The mean cost per survivor was 26056 USD, whereas that of a non-survivor was 18500 USD. The cost-benefit ratio, i.e. calculated cost per year of extended life until the age of 75 years, averaged 1420 USD (range 360-7980 USD). With the exception of patient suffering from cancerous diseases, the cost-benefit ratio found in this study was favourable in comparison to other high-cost medical care. This is further emphasized by the fact that for the years saved, the quality of life was mostly good.