BENEFIT-COST ANALYSIS OF VENTILATOR-ASSOCIATED PNEUMONIA (VAP) BUNDLE CARE IN TERTIARY CARE HOSPITALS OF INDIA...
Author(s)
Dhaval Parmar, Sr., PhD1, Medha Wadhwa, PhD1, Abhigya Khichi, MPH1, Devang R. Raval, MPH1, Somen Saha, PhD1, Archana Thakur, MD1, Junaid KP, PhD1, Astha Vala, MD2, Dr A. M. Kadri, MD2, Deepak B. Saxena, PhD1.
1Indian Institute of Public Health Gandhinagar, Gandhinagar, India, 2State Health System Resource Centre Gujarat, Gandhinagar, India.
1Indian Institute of Public Health Gandhinagar, Gandhinagar, India, 2State Health System Resource Centre Gujarat, Gandhinagar, India.
OBJECTIVES: Ventilator-associated pneumonia (VAP) is a common healthcare-associated infection in intensive care units (ICUs) and is associated with prolonged hospital stay and increased treatment costs. This study assessed the economic implications of implementing ventilator bundle care in tertiary care hospitals of Gujarat, India.
METHODS: A benefit-cost analysis (BCA) was carried out across three tertiary hospitals, comprising two private trust-based hospitals and one government hospital. Hospital surveillance and costing data for the year 2024 were collected, including ventilator-days, VAP rates, bundle compliance, and incremental costs of consumables, human resources, training, and administration. Expected VAP cases were estimated using the International Nosocomial Infection Control Consortium (INICC) 2016 benchmark. VAP treatment costs were obtained from published Indian literature and adjusted to December 2024 price levels. Benefit-cost ratio (BCR), net monetary benefit (NMB), opportunity cost, and one-way sensitivity analysis were estimated.
RESULTS: Bundle compliance ranged from 66% to 94%; higher compliance correlated with lower VAP rates. Hospital A recorded the highest VAP rate (5.6 per 1,000 ventilator-days), followed by Hospital B (0.9) and Hospital C (0.4). The estimated number of VAP cases prevented was 20 in Hospital A, 27 in Hospital B, and 44 in Hospital C. Annual bundle implementation costs ranged from INR 20.7 lakh to INR 36.9 lakh. The BCR ranged between 1.76 and 3.33 across hospitals, indicating positive economic returns in all settings. Net monetary benefit ranged from INR 28.1 lakh to INR 67.3 lakh. Sensitivity analysis showed that the number of cases prevented and incremental VAP cost had the greatest influence on economic outcomes.
CONCLUSIONS: VAP bundle care showed favourable economic returns across all study hospitals. Greater compliance with bundle practices was associated with lower VAP rates and improved economic outcomes. The findings support continued strengthening of VAP prevention practices and compliance monitoring in tertiary ICUs.
METHODS: A benefit-cost analysis (BCA) was carried out across three tertiary hospitals, comprising two private trust-based hospitals and one government hospital. Hospital surveillance and costing data for the year 2024 were collected, including ventilator-days, VAP rates, bundle compliance, and incremental costs of consumables, human resources, training, and administration. Expected VAP cases were estimated using the International Nosocomial Infection Control Consortium (INICC) 2016 benchmark. VAP treatment costs were obtained from published Indian literature and adjusted to December 2024 price levels. Benefit-cost ratio (BCR), net monetary benefit (NMB), opportunity cost, and one-way sensitivity analysis were estimated.
RESULTS: Bundle compliance ranged from 66% to 94%; higher compliance correlated with lower VAP rates. Hospital A recorded the highest VAP rate (5.6 per 1,000 ventilator-days), followed by Hospital B (0.9) and Hospital C (0.4). The estimated number of VAP cases prevented was 20 in Hospital A, 27 in Hospital B, and 44 in Hospital C. Annual bundle implementation costs ranged from INR 20.7 lakh to INR 36.9 lakh. The BCR ranged between 1.76 and 3.33 across hospitals, indicating positive economic returns in all settings. Net monetary benefit ranged from INR 28.1 lakh to INR 67.3 lakh. Sensitivity analysis showed that the number of cases prevented and incremental VAP cost had the greatest influence on economic outcomes.
CONCLUSIONS: VAP bundle care showed favourable economic returns across all study hospitals. Greater compliance with bundle practices was associated with lower VAP rates and improved economic outcomes. The findings support continued strengthening of VAP prevention practices and compliance monitoring in tertiary ICUs.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE114
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas