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Summary: Economic impact of changes in neonatal intensive care unit ventilation strategies with the advent of new noninvasive ventilation techniques: a review and proposed assessment framework for high flow therapy as a routine respiratory support paradigm.
Topic: Economics
Pietzsch JB, Garner AM, McQueen M. Economic impact of changes in neonatal intensive care unit ventilation strategies with the advent of new noninvasive ventilation techniques: a review and proposed assessment framework for high flow therapy as a routine respiratory support paradigm. JHEOR. 2015;3(1):34-42. doi:10.36469/9840
In 2015, Pietszch and colleagues published the “Economic Impact of Changes in NICU Ventilation Strategies with the Advent of New Noninvasive Ventilation Techniques: A Review and Proposed Assessment Framework for High Flow Therapy (HFT) as a Routine Respiratory Support Paradigm” in the Journal of Health Economics and Outcomes Research providing a quantitative framework based on available evidence to estimate the economic impact of adoption of a HFT respiratory support strategy compared to current standard of care. In the report, the authors constructed a model to estimate total cost per NICU episode of care by treatment strategy, considering the utilization and duration of the following types of ventilatory support modalities – conventional mechanical ventilation (CMV), nasal continuous positive airway pressure (nCPAP) ventilation, and HFT, as well as utilization levels of surfactant, chest x-rays, blood gas analyses and total NICU length of stay.
The report used the model parameters from five US-based NICUs adopting a HFT strategy and a larger pool of NICUs in the Vermont-Oxford Network (VON) and computed the total cost difference between the respiratory support strategies based on published cost data. The computed results showed a total average length of ventilation of 25.48 days for the non-HFT strategy (8.92 days nCPAP, 6.10 days HFT, 10.47 days CMV) and of 25.06 days (2.88 days nCPAP, 16.86 days HFT, 5.32 days CMV) for the HFT strategy. These results revealed that HFT was associated with total projected cost savings of $2,317.
The model concluded that adoption of a HFT strategy appears to be associated with meaningful savings in total NICU episode of care costs, primarily resulting from reductions in the time of conventional mechanical ventilation. Further research is warranted to substantiate these findings.
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