For a study, the researchers compared specialized weaning centers (SWC) survivors’ survival, health-care consumption, and expenses to a matched sample of ICU patients with a 21-day stay. The research conducted was a 12-year retrospective case-control research linked to health administrative databases and matched age, sex, Charlson comorbidity index, income quintiles, and days in ICU and hospital in the previous 12 months. Investigators matched 201 SWC individuals with 201 protracted ICU survivors (402-subject cohort); 42% of the SWC subjects had a Charlson score of more than 4. After correcting for a length of hospital stay (hazard ratio [HR] 1.02 [95% CI 1.00–1.04]) and frequency of care location changes (HR 0.84 [95% CI 0.75–0.93], the risk of death in SWC individuals was decreased (HR 0.70 [95% CI 0.54–0.91]). By the end of the study, 149 SWC subjects had died (73%) compared to 127 SWC subjects (62%). There was no discernible difference in discharge to home. Acute healthcare usage was similar across the sample at 12 months, with the exception of hospital readmission rates (median, interquartile range [IQR] 2 [1–3] versus 1 [1–2] d). About 12 months following unit release, the median (IQR) cost was CAD $68,165 ($19,894–$153,475). The SWC survivors’ 12-month expenses were greater (CAD $82,874 [$29,942–$224,965] versus CAD $55,574 [$6,572–$128,962], P<.001). SWC survivors used community health care more frequently. The cost was linked to stay and care transfers, but not to SWC admission, according to regression modeling. Healthcare utilization and expenses were higher among SWC survivors after a 12-year follow-up. SWC admission might have offered a medium-term survival advantage; however, selection bias linked with admission criteria might have influenced this.
Source:rc.rcjournal.com/content/67/3/291
