Abstract
Costs of care in the intensive care unit are a frequent target for concern in the
current health care system. Utilization of critical care services in the United States
is increasing and will continue to do so. Acute respiratory distress syndrome (ARDS)
is a common and important complication of critical illness. Patients with ARDS frequently
have long hospitalizations and consume a significant amount of health care resources.
Many patients are discharged with functional limitations and high susceptibility to
new complications that require significant additional health care resources. There
is increasing literature on the cost-effectiveness of the treatment of ARDS, and despite
its high costs, treatment remains a cost-effective intervention by current societal
standards. However, when ARDS leads to prolonged mechanical ventilation, treatment
becomes less cost-effective. Current research seeks to find interventions that lead
to reductions in duration of mechanical ventilation and intensive care unit (ICU)
length of stay. Limited reductions in ICU length of stay have benefits for the patient,
but they do not lead to significant reductions in overall hospital costs. Early discharge
to post–acute care facilities can reduce hospital costs but are unlikely to decrease
costs for an entire episode of illness. Improved effectiveness of communication between
clinicians and patients or their surrogates could help avoid costly interventions
with poor expected outcomes.
Keywords
ARDS - mechanical ventilation - critical care - costs and cost analysis
