Title

The financial costs associated with respiratory physiotherapy for ventilator-associated pneumonia in patients with acquired brain injury

Abstract

This study provides the first description of the financial costs of respiratory physiotherapy for patients with acquired brain injury (ABI) in the intensive care unit (ICU) aimed at decreasing the incidence of ventilator-associated pneumonia (VAP), duration of mechanical ventilation (MV) and length of ICU stay. Consent was obtained for 144 adult ABI patients admitted with a Glasgow Coma Scale ≤ 9, requiring intracranial pressure monitoring, and invasive MV for > 24 hours, with randomisation to a treatment group (six respiratory physiotherapy treatments in each 24-hour period whilst ventilated, n = 72), or a control group (routine medical and nursing care only, n = 72). Respiratory physiotherapy comprised positioning, manual hyperinflation and suctioning. For subjects with ABI receiving prophylactic physiotherapy, the respiratory physiotherapy cost was $487.00 per subject. In comparison, ICU bed-days cost for the period of MV was $33 380.00 per subject. Thirty-three subjects (23%) developed VAP (14 from the prophylactic treatment group) and were re-randomised eto a treatment group (n = 17), or a control group (n = 16). For subjects with VAP, the total respiratory physiotherapy cost was $1029.00 per subject, compared to $510.00 for subjects without VAP. The respective ICU bed-days cost for the period of MV per subject was $61 092.00 and $25 142.00, giving an incremental health cost of $35 950.00 per episode of VAP. The cost of respiratory physiotherapy as a percent of their ICU bed-days cost for the period of MV was 1.4 % in those with VAP and 1.1 % in those without VAP.

Patman, S., Stiller, K., & Jenkins, S. (2006). The financial costs associated with respiratory physiotherapy for ventilator-associated pneumonia in patients with acquired brain injury. Australian Journal of Physiotherapy, 52(1), S23.

ISSN: 0004-9514

Comments

The Australian Journal of Physiotherapy is published by the Australian Physiotherapy Association and may be accessed here

The Australian Journal of Physiotherapy may be accessed from Libraries Australia here

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