Ventilator-associated pneumonia among elderly Medicare beneficiaries in long-term care hospitals

Abstract

Ventilator-associated pneumonia (VAP) is a complication of ventilator care that produces excess, avoidable resource use and treatment costs. Control of VAP is an important aspect of quality of care improvement for long-term care hospitals (LTCHs) since they provide post-acute ventilator care for many Medicare beneficiaries. Data for Medicare patients discharged from LTCHs during CY 2004 who received continuous mechanical ventilation are examined (N=13,759). Nearly 25% of Medicare LTCH ventilator patients acquired VARP Despite having lower mortality and less co-morbidity than non-VAP patients, length of stay (LOS) and total charges were both higher for VAP patients. Some of this excess is avoidable.

Figure 1. Post-Discharge Survival for LTCH Continuous Mechanical Ventilation Patients