1263. The Cost of Ventilator-Associated Events at an Academic Medical Center
Session: Oral Abstract Session: Device and Procedure Related HAIs
Friday, October 9, 2015: 2:45 PM
Room: 32--ABC
Background:

Surveillance definitions for ventilator-associated events (VAE) were released in 2013 as the definition for ventilator-associated pneumonia (VAP) was phased out in the adult population.  Hospital costs attributed to VAP range in various studies from $12,000-$40,000 per event, but cost modeling for VAE has not yet been reported.  In this study we determined the attributable cost of VAEs at Vanderbilt University Medical Center for fiscal year 2014 (July 1, 2013-June 30, 2014) using a conservative fiscal model.

Methods:

We calculated the increased cost of care due to the condition of interest (i.e. variable direct cost) for Ventilator-Associated Conditions (VACs), Infection-Related Ventilator-Associated Conditions (IVACs), and Probable/Possible Ventilator-Associated Pneumonias (PR/POVAP).  For comparison, variable direct costs were also calculated for central-line related bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI).   Cost was captured beginning on the day after the event and was limited to either seven days post-event or to the date of discharge, whichever was sooner.  For patients with more than one VAE during the same hospitalization, only the first event was included.  To keep the model conservative we did not consider post-acute costs, readmission cost, or potential incremental revenue attributed to freed bed capacity from length of stay reductions.

Results:

Of 11,154 ventilator-days, 135 VAEs occurred. 129 VAEs were eligible for analysis, resulting in the following costs:

Infection Type

Event Count

Mean Cost Per Event

Median Cost Per Event

Total Variable Direct Cost for All Events

VAC

 

67

$ 10,848

$ 9,774

$ 726,806

IVAC

 

35

$ 20,278

$ 15,851

$ 709,736

PR/POVAP

 

27

$ 16,346

$ 15,498

$ 441,351

All VAE

129

$ 14,557

$ 11,790

$ 1,877,893

With a mean cost of $14,557 per event, VAEs were more costly than both CAUTI ($10,287 per event) and CLABSI ($11,607 per event).  VAEs were also the most costly of the infections examined on an aggregate level generating a cost of nearly $1.9 million compared to CAUTI ($1.3 million) and CLABSI ($1.4 million).  

Conclusion:

VAEs lead to substantial costs, even using a conservative analysis model.

Bryan Harris, MD1, Charisse Dillree, BS2, John Wolfe, BS2, Gale Woodland, BS3 and Thomas Talbot, MD, MPH, FIDSA, FSHEA4, (1)Infectious Diseases, Vanderbilt University, Nashville, TN, (2)Finance-Decision Support, Vanderbilt University Medical Center, Nashville, TN, (3)Innovation Integration Center, Vanderbilt University Medical Center, Nashville, TN, (4)Vanderbilt University, Nashville, TN

Disclosures:

B. Harris, None

C. Dillree, None

J. Wolfe, None

G. Woodland, None

T. Talbot, None

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