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International Journal of Pediatrics
Volume 2012, Article ID 359430, 6 pages
Research Article

Economic Analysis of a Pediatric Ventilator-Associated Pneumonia Prevention Initiative in Nicaragua

1University Research Co., LLC and EnCompass LLC, 7200 Wisconsin Avenue No. 600, Bethesda, MD 20814, USA
2Componente Materno Infantil, University Research Co., LLC, De La Vicky 1, Cuarda al Oeste 1, Edificio Plaza San Ramon, 2° Nivel, Puerta 7, Managua, Nicaragua
3Comité de Infecciones Intrahospitalarias, Infantil Manuel Jesus Rivera Hospital, Barrio Ariel Darce, Managua, Nicaragua
4Departamento de Neonatología, Bertha Calderón Hospital, Del Centro Comercial Zumen 1, Cuadra al Oeste, Managua, Nicaragua

Received 27 June 2011; Revised 31 October 2011; Accepted 2 November 2011

Academic Editor: P. D. Brophy

Copyright © 2012 Edward I. Broughton et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We performed an economic analysis of an intervention to decrease ventilator-associated pneumonia (VAP) prevalence in pediatric intensive care units (PICUs) at two Nicaraguan hospitals to determine the cost of the intervention and how effective it needs to be in order to be cost-neutral. A matched cohort study determined differences in costs and outcomes among ventilated patients. VAP cases were matched by sex and age for children older than 28 days and by weight for infants under 28 days old to controls without VAP. Intervention costs were determined from accounting and PICU staff records. The intervention cost was approximately $7,000 for one year. If VAP prevalence decreased by 0.5%, hospitals would save $7,000 and the strategy would be cost-neutral. The finding that the intervention required only modest effectiveness to be cost-neutral and has potential to generate substantial cost savings argues for implementation of VAP prevention strategies in low-income countries like Nicaragua on a broader scale.