EVALUATION OF AN INTERDISCIPLINARY INPATIENT WEANING PROGRAM FOR PROLONGED MECHANICAL VENTILATION: MATCHED COHORT RESULTS FROM THE "LEBENSLUFT" PROJECT
Author(s)
Daniel Gensorowsky, PhD1, Darja Baban, MSc1, Manuel Streuter, MD2, Mathias Lehmann, -2, Benoit Krämer-Relius, MD2, Kurt Rasche, MD3, Matthias Mohrmann, Dipl.-Kfm.4, Stefan Lopez Seijas, MSc4, Wolfgang Greiner, PhD5.
1Vandage GmbH, Bielefeld, Germany, 2Helios Klinikum Krefeld, Krefeld, Germany, 3Helios Klinikum Wuppertal, Barmen, Germany, 4AOK Rheinland/Hamburg, Düsseldorf, Germany, 5Bielefeld University, Bielefeld, Germany.
1Vandage GmbH, Bielefeld, Germany, 2Helios Klinikum Krefeld, Krefeld, Germany, 3Helios Klinikum Wuppertal, Barmen, Germany, 4AOK Rheinland/Hamburg, Düsseldorf, Germany, 5Bielefeld University, Bielefeld, Germany.
OBJECTIVES: To assess whether participation in Lebensluft, an interdisciplinary inpatient program for medium-term ventilator weaning, was associated with higher weaning success and lower follow-up health care costs than matched controls receiving usual care with ongoing ventilation.
METHODS: This retrospective matched cohort study used statutory health insurance claims from AOK Rheinland/Hamburg and clinical data from Lebensluft sites in Krefeld and Wuppertal, Germany, covering April 2015 to March 2024. Analyses included patients transferred to Lebensluft after an index hospitalization and a matched control group identified from claims data. Matching combined exact and propensity score methods. The primary outcome was weaning success within 365 days, defined as the first 40-day interval without documented inpatient or home ventilation services. Secondary outcomes included mortality, health care resource use, and costs.
RESULTS: 260 inpatient Lebensluft patients were matched 1:1 to controls. Weaning success was achieved by 59.6% of Lebensluft patients versus 24.6% of matched controls; sustained weaning through the end of follow-up occurred in 46.2% versus 4.2%, respectively. The incidence rate of successful weaning was significantly higher with Lebensluft (adjusted incidence rate ratio 2.45; 95% CI 1.75-3.52; p<0.001). After 200 days, 51.3% of Lebensluft patients versus 20.9% of controls had achieved weaning. Twelve-month mortality was similar between groups (39.2% vs 42.3%). Compared with controls, Lebensluft patients had fewer outpatient physician contacts (-12.2; p<0.001), fewer hospitalizations (-0.6; p=0.029), fewer ventilation hours (-306.7; p<0.001), but more hospital days (+22.9; p<0.001). Mean total costs were substantially lower with Lebensluft (€84,292 vs €258,839; difference -€174,547; p<0.001), mainly driven by lower home nursing/out-of-hospital intensive care costs (-€122,938; p<0.001).
CONCLUSIONS: In this matched cohort study, the Lebensluft program was associated with markedly higher weaning success and substantially lower follow-up costs, without differences in mortality. The study design does not permit definitive causal inference, but findings support interdisciplinary inpatient weaning structures as a potentially high-value care model.
METHODS: This retrospective matched cohort study used statutory health insurance claims from AOK Rheinland/Hamburg and clinical data from Lebensluft sites in Krefeld and Wuppertal, Germany, covering April 2015 to March 2024. Analyses included patients transferred to Lebensluft after an index hospitalization and a matched control group identified from claims data. Matching combined exact and propensity score methods. The primary outcome was weaning success within 365 days, defined as the first 40-day interval without documented inpatient or home ventilation services. Secondary outcomes included mortality, health care resource use, and costs.
RESULTS: 260 inpatient Lebensluft patients were matched 1:1 to controls. Weaning success was achieved by 59.6% of Lebensluft patients versus 24.6% of matched controls; sustained weaning through the end of follow-up occurred in 46.2% versus 4.2%, respectively. The incidence rate of successful weaning was significantly higher with Lebensluft (adjusted incidence rate ratio 2.45; 95% CI 1.75-3.52; p<0.001). After 200 days, 51.3% of Lebensluft patients versus 20.9% of controls had achieved weaning. Twelve-month mortality was similar between groups (39.2% vs 42.3%). Compared with controls, Lebensluft patients had fewer outpatient physician contacts (-12.2; p<0.001), fewer hospitalizations (-0.6; p=0.029), fewer ventilation hours (-306.7; p<0.001), but more hospital days (+22.9; p<0.001). Mean total costs were substantially lower with Lebensluft (€84,292 vs €258,839; difference -€174,547; p<0.001), mainly driven by lower home nursing/out-of-hospital intensive care costs (-€122,938; p<0.001).
CONCLUSIONS: In this matched cohort study, the Lebensluft program was associated with markedly higher weaning success and substantially lower follow-up costs, without differences in mortality. The study design does not permit definitive causal inference, but findings support interdisciplinary inpatient weaning structures as a potentially high-value care model.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD119
Topic
Clinical Outcomes, Economic Evaluation, Health Service Delivery & Process of Care
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)