Cost comparison of mechanically ventilated patients across the age span

OBJECTIVE: To compare the use of mechanical ventilation and hospital costs across ventilated patients of all ages, preterm through adults, in a nationally representative sample. STUDY DESIGN: Secondary analysis of the 2009 Agency for Healthcare Research and Quality National Inpatient Sample. RESULTS: A total of 1 107 563 (2.8%) patients received mechanical ventilation. For surviving ventilated patients, median costs for infants <= 32 weeks' gestation were $51000 to $209 000, whereas median costs for older patients were lower from $17000 to $25 000. For non-surviving ventilated patients, median costs were $27 000 to $39 000 except at the extremes of age; the median cost was $10000 for <24 week newborns and $14000 for 91+ year adults. Newborns of all gestational ages had a disproportionate share of hospital costs relative to their total volume. CONCLUSION: Most intensive care unit resources at the extremes of age are not directed toward non-surviving patients. From a perinatal perspective, attention should be directed toward improving outcomes and reducing costs for all infants, not just at the earliest gestational ages.