Comparison of Quality of Medical Care for Prolonged Mechanical Ventilation Patients with and without Ventilator-Associated Pneumonia

Chih-Hung Lin ； Jin-Yin Chang

《胸腔醫學》 35卷1期 (2020/03) Pp. 28-34

摘要

Background: The number of patients on prolonged mechanical ventilation in Taiwan is increasing every year because of the aging population, the increase in chronic diseases, and recent advances in medical equipment. Ventilator use often leads to complications, such as ventilator-associated pneumonia, and increased health care resource utilization. Methods: This study used secondary data from Taiwan's National Health Insurance Research Database, Longitudinal Health Insurance Dataset, 2010 (LHID2010) provided by the Ministry of Health and Welfare. The study period was 2008-2012. The total number of patients was 2,992; there were 1,048 long-term ventilator-dependent patients without ventilator-associated pneumonia and 1,944 patients with ventilator-associated pneumonia. Logistic regression analysis was used to explore the odds ratio for the quality of medical care results between ventilator-dependent patients with and without ventilator-associated pneumonia. Results: The quality of medical care results showed that there was a statistically significant correlation between multiple readmissions to the intensive care unit and hospital deaths and long-term respiratory disease without lung cancer; there was also a statistically significant correlation with demographic characteristics at the hospital level. Conclusion: Follow-up research using the questionnaire or long-term medical record tracking to further explore the results of medical care, such as weaning success, in-hospital death, and nosocomial infection among ventilator-dependent patients with different respiratory diseases is needed.

關鍵字

prolonged mechanical ventilation patients ； pneumonia in prolonged mechanical ventilation patients ； quality of medical care