Economics of Mechanical Ventilation

Critical care services consume a large share of health-care resources, many of which are devoted to the care of ventilator-dependent patients who often require prolonged support. The precise determination of costs of mechanical ventilation is quite complex and may even be elusive. This results from several factors, including the difficulty inherent in separating the “technology” of mechanical ventilation from the reason for its use, variable cost accounting methodologies used by different institutions, and the overlap between direct and indirect costs that accrue. Furthermore, cost determinations of ventilator dependency must be distinguished from cost effectiveness, the latter linking clinical outcome and utility to the amount of resources expended. In view of the heightened concern for cost containment, impending health care reform, and changes in health care reimbursement, the pulmonary and critical care physician must become familiar with the economics of mechanical ventilation. Doing so will facilitate financial savings without sacrificing clinical quality.