Healthcare resource use and costs in long-term survivors of acute respiratory distress syndrome: A 5-year longitudinal cohort study

A. Parker Ruhl, Minxuan Huang, Elizabeth Colantuoni, Robert K. Lord, Victor D. Dinglas, Alexandra Chong, Kristin A. Sepulveda, Pedro A. Mendez-Tellez, Carl B. Shanholtz, Donald M. Steinwachs, Peter J. Pronovost, Dale M. Needham

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Objective: To evaluate the time-varying relationship of annual physical, psychiatric, and quality of life status with subsequent inpatient healthcare resource use and estimated costs. Design: Five-year longitudinal cohort study. Setting: Thirteen ICUs at four teaching hospitals. Patients: One hundred thirty-eight patients surviving greater than or equal to 2 years after acute respiratory distress syndrome. Interventions: None. Measurements and Main Results: Postdischarge inpatient resource use data (e.g., hospitalizations, skilled nursing, and rehabilitation facility stays) were collected via a retrospective structured interview at 2 years, with prospective collection every 4 months thereafter, until 5 years postacute respiratory distress syndrome. Adjusted odds ratios for hospitalization and relative medians for estimated episode of care costs were calculated using marginal longitudinal two-part regression. The median (interquartile range) number of inpatient admission hospitalizations was 4 (2-8), with 114 patients (83%) reporting greater than or equal to one hospital readmission. The median (interquartile range) estimated total inpatient postdischarge costs over 5 years were $58,500 ($19,700-157,800; 90th percentile, $328,083). Better annual physical and quality of life status, but not psychiatric status, were associated with fewer subsequent hospitalizations and lower follow-up costs. For example, greater grip strength (per 6 kg) had an odds ratio (95% CI) of 0.85 (0.73-1.00) for inpatient admission, with 23% lower relative median costs, 0.77 (0.69-0.87). Conclusions: In a multisite cohort of long-term acute respiratory distress syndrome survivors, better annual physical and quality of life status, but not psychiatric status, were associated with fewer hospitalizations and lower healthcare costs.

Original languageEnglish (US)
Pages (from-to)196-204
Number of pages9
JournalCritical care medicine
Volume45
Issue number2
DOIs
StatePublished - Feb 1 2017

Keywords

  • critical illness
  • health care costs
  • intensive care unit
  • patient readmission
  • respiratory distress syndrome, acute

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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