The Health Care ManagerCritical Care Beds With Continuous Lateral Rotation Therapy to Prevent Ventilator-Associated Pneumonia and Hospital-Acquired Pressure Injury: A Cost-effectiveness AnalysisKang, So-Yeon MPH, MBA∗; DiStefano, Michael J. MBE∗; Yehia, Farah MPH∗; Koszalka, Maria V. RN, EdD†; Padula, William V. PhD‡,§,∥Author Information From the ∗Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD †Johns Hopkins Bayview Medical Center, Baltimore, MD ‡Leonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles, CA §Department of Pharmaceutical & Health Economics, School of Pharmacy, University of Southern California, Los Angeles, CA ∥Department of Acute & Chronic Care, Johns Hopkins School of Nursing, Baltimore, MD. Correspondence: William V. Padula, PhD, USC Schaeffer Center, 635 Downey Way (VPD), Los Angeles, CA, 90089 (e-mail: [email protected]). The authors disclose no conflict of interest. Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.journalpatientsafety.com). Journal of Patient Safety: March 2021 - Volume 17 - Issue 2 - p 149-155 doi: 10.1097/PTS.0000000000000582 Buy SDC Metrics Abstract Objectives Mechanical ventilation increases the risk of hospital-acquired conditions (HACs) such as ventilator-associated pneumonia (VAP) and pressure injury (PrI). Beds with continuous lateral rotation therapy (CLRT) are shown to reduce HAC incidence, but the value of switching to CLRT beds is presently unknown. We compared the cost-effectiveness of CLRT beds with standard care in intensive care units. Methods A cost-effectiveness analysis from the healthcare sector and societal perspectives was conducted. A Markov model was constructed to predict health state transitions from time of ventilation through 28 days for the healthcare sector perspective and 1 year for the U.S. societal perspective. Value of information was calculated to determine whether parameter uncertainty warranted further research. Results Our analysis suggested that CLRT beds dominate standard care from both perspectives. From the healthcare sector perspective, expected cost for CLRT was U.S. $47,165/patient compared with a higher cost of U.S. $49,258/patient for standard care. The expected effectiveness of CLRT is 0.0418 quality-adjusted life years/patient compared with 0.0416 quality-adjusted life years/patient for standard care. Continuous lateral rotation therapy dominated standard care in approximately 93% of Monte Carlo simulations from both perspectives. Value of information analysis suggests that additional research is potentially cost-effective. Conclusions Continuous lateral rotation therapy is highly cost-effective compared with standard care by preventing HACs that seriously harm patients in the intensive care unit. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.