Hospital costs in patients receiving prolonged mechanical ventilation: Does age have an impact?

Critical Care Medicine

Volumn 31, Issue 6, 2003, Pages 1746-1751

  Chelluri, Lakshmipathi ^a,c   Mendelsohn, Aaron B ^b   Belle, Steven H ^b   Rotondi, Armando J ^a   Angus, Derek C ^a   Donahoe, Michael P ^a   Sirio, Carl A ^a   Schulz, Richard ^b   Pinsky, Michael R ^a  

^a UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE   (United States)

^b UNIVERSITY OF PITTSBURGH   (United States)

^c UNIVERSITY OF PITTSBURGH MEDICAL CENTER   (United States)

Author keywords

Age; Costs; Intensive care; Mechanical ventilation

Indexed keywords

ADULT; AGE; AGED; ARTICLE; ARTIFICIAL VENTILATION; COMORBIDITY; FEMALE; HEALTH CARE COST; HEALTH CARE UTILIZATION; HOSPITAL COST; HOSPITALIZATION; HUMAN; INTENSIVE CARE; MAJOR CLINICAL STUDY; MALE; MORTALITY; PRIORITY JOURNAL; PROSPECTIVE STUDY; SCORING SYSTEM;

ADOLESCENT; ADULT; AGE FACTORS; AGED; AGED, 80 AND OVER; APACHE; FEMALE; HOSPITAL COSTS; HOSPITAL MORTALITY; HUMANS; INTENSIVE CARE UNITS; LENGTH OF STAY; LOGISTIC MODELS; MALE; MIDDLE AGED; MULTIVARIATE ANALYSIS; PROSPECTIVE STUDIES; RESPIRATION, ARTIFICIAL;

EID: 0038806279     PISSN: 00903493     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.CCM.0000063478.91096.7D     Document Type: Article

References (35)

1. Lassman D, McDonald E. Revenue for Health Care and Social Assistance Up 4 Percent, Census Bureau Reports. Washington, DC, United States Department of Commerce News. Available at: www.census.gov/Press-Release/www/2001/cb01-21.html. Accessed August 15, 2001.
2. Spillman BC, Lubitz J: The effect of longevity on spending for acute and long-term care. N Engl J Med 2000; 342:1409-1415
3. Lubitz J, Greenberg LG, Gorina Y, et al: Three decades of health care use by the elderly, 1965-1998. Health Affairs 2001; 20: 19-32
4. Wagner DP: Economics of prolonged mechanical ventilation. Am Rev Resp Dis 1989; 140:S14-S18
5. Ridley S, Biggam M, Stone P: Cost of intensive therapy: A description of methodology and initial results. Anaesthesia 1991; 46: 523-530
6. Rapoport J, Teres D, Lemeshow S, et al: Explaining variability of cost using a severity-of-illness measure for ICU patients. Medical Care 1990; 28:338-348
7. Epstein AM, Ayanian JZ, Keogh JH, et al: Racial disparities in access to renal transplantation: Clinically appropriate or due to underuse or overuse? N Engl J Med 2000; 343:1537-1544
8. Rathore SS, Berger AK, Weinfurt KP, et al: Race, sex, poverty, and the medical treatment of acute myocardial infarction in the elderly. Circulation 2000; 102:642-648
9. Gan SC, Beaver SK, Houck PM, et al: Treatment of acute myocardial infarction and 30-day mortality among women and men. N Engl J Med 2000; 343:8-15
10. Buckle JM, Horn SD, Oates VM, et al: Severity of illness and resource use differences among white and black hospitalized elderly. Arch Intern Med 1992; 152: 1596-1603
11. Campion EW, Mulley AG, Goldstein RL, et al: Intensive care for the elderly: A study of current use, costs and outcomes. JAMA 1981; 246:2052-2056
12. McLish DK, Powell SH, Montenegro H, et al: The impact of age on utilization of intensive care resources. J Am Geriatr Soc 1987; 35: 983-988
13. Chalfin DB, Carlon GC: Age and utilization of intensive care unit resources of critically ill cancer patients. Crit Care Med 1990; 18: 694-698
14. Hamel MB, Davis RB, Teno JM, et al: Older age, aggressiveness of care, and survival for seriously ill, hospitalized adults. Ann Intern Med 1999; 131:721-728
15. Hamel MB, Teno JM, Goldman L, et al: Patient age and decisions to withhold life-sustaining treatments from seriously ill, hospitalized adults. Ann Intern Med 1999; 130:116-125
16. Hamel MB, Phillips RS, Teno JM, et al: Seriously ill hospitalized adults: do we spend less on older patients? J Am Geriatr Soc 1996; 44:1043-1048
17. Perls TT, Wood ER: Acute care costs of the oldest old: they cost less, their care intensity is less, and they go to nonteaching hospitals. Arch Intern Med 1996; 156:754-760
18. Boyd K, Teres D, Rapoport J, et al: The relationship between age and the use of DNR orders in critical care patients: Evidence for age discrimination. Arch Intern Med 1996; 156:1821-1826
19. Ely EW, Evans GW, Haponik EF: Mechanical ventilation in a cohort of elderly patients admitted to an intensive care unit. Ann Intern Med 1999; 131:96-104
20. Angus DC, Linde-Zwirble WT, Lidicker J, et al: Incidence and outcome of severe sepsis in the United States. Crit Care Med 2001; 29: 1303-1310
21. Quality of Life After Mechanical Ventilation in the Aged (QOL-MV) Study Investigators. Two-month mortality and functional status of critically ill adult patients receiving prolonged mechanical ventilation. Chest 2002; 121:549-558
22. Charlson ME, Pompei P, Ales KL: A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chron Dis 1987; 40:373-383
23. Knaus WA, Wagner DP, Draper E, et al: The APACHE III prognostic system: Risk prediction of hospital mortality for critically ill hospitalized adults. Chest 1991; 100:1619-1636
24. Auerbach AD, Hamel MB, Davis RB, et al: Resource use and survival of patients hospitalized with congestive heart failure: Differences in care by specialty of the attending physician. Ann Intern Med 2000; 132:191-200
25. Shwartz M, Iezzoni LI, Moskowitz MA, et al: The importance of comorbidities in explaining differences in patient costs. Medical Care 1996; 34:767-782
26. Hosmer DW, Lemeshow S: Applied Logistic Regression. New York, NY, John Wiley & Sons, 1989
27. Fedullo AJ, Swinburne AJ: Relationship of patient age to cost and survival in a medical ICU. Crit Care Med 1983; 11:155-159
28. Castillo-Lorente E, Rivera-Fernandez R, Vazquez-Mata G: Limitation of therapeutic activity in elderly critically ill patients. Crit Care Med 1997; 25:1643-1648
29. Ozua EI, Chelluri L: The Influence of age on the limitation of life support: A systematic review of the literature. Chest 2000;118: 126S.
30. Chard R, Lamm D: The brave new world of health care. Ann Thorac Surg 1991; 52: 369-384
31. Williams A: The rationing debate: Rationing health care by age: The case for. BMJ 1997; 314:820-822
32. Williams M: Rationing health care: Can a "fair innings" ever be fair? Letter. BMJ 1997; 314:514
33. Bowling A: Rationing health care: Access to treatment should be equal, regardless of age. Letter. BMJ 1997; 314:1902
34. Bowling A: Health care rationing: The public's debate. BMJ 1996; 312:670-674
35. Shwartz M, Young DW, Siegrist R. The ratio of costs to charges: How good a basis for estimating costs? Inquiry 1995/96;32: 476-481