Long-Term Survival and Medical Costs of Patients with Prolonged Mechanical Ventilation and Tracheostomy: A Nationwide Cohort Study

Hui-Hsuan Lai, Pei-Ying Tseng, Chen-Yu Wang and Jong-Yi Wang
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Hui-Hsuan Lai: Department of Nursing, China Medical University Hospital, Taichung 404332, Taiwan
Pei-Ying Tseng: Department of Public Health, China Medical University, Taichung 406040, Taiwan
Chen-Yu Wang: Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung 407752, Taiwan
Jong-Yi Wang: Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan

IJERPH, 2021, vol. 18, issue 19, 1-10

Abstract: Few large-scale studies have focused on tracheostomy in patients with prolonged mechanical ventilation. This retrospective population-based study extracted data from the longitudinal National Health Insurance Research Database in Taiwan to compare long-term mortality between patients on prolonged mechanical ventilation with and without tracheostomy and their related medical expenditures. Data on newly developed respiratory failure in patients on ventilator support were extracted from 1 January 2002 to 31 December 2008. Of 10,705 patients included, 1372 underwent tracheostomy (n = 563) or translaryngeal intubation (n = 779). Overall survival of the patients with tracheostomy was followed for 5 years. Average survival was 4.98 years for the patients with tracheostomy and 5.48 years for the patients with translaryngeal intubation (not significant). Sex, age, premium-based monthly salary difference, occupation, urbanization level, chronic obstructive pulmonary disease, chronic heart failure, chronic renal disease, and cerebrovascular diseases were significantly associated with mortality for endotracheal intubation. Male sex, chronic heart failure, chronic renal disease, age ?45 years, and low income were associated with significantly higher mortality. Although total medical expenditures were higher for the patients with tracheostomy, annual medical expenditures were not significantly different. There were no differences in long-term mortality between the two groups.

Keywords: tracheotomy; mechanical ventilator; mortality; survival analysis; medical expense (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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