Prolonged Mechanical Ventilation in Ontario ICU

To inform planning, policy and provincial program development for prolonged and long-term ventilation that will benefit the entire Ontario health system based on the following:

• Program collaboration across the continuum of critical illness can prevent resource waste and create seamless transitions for patients and family experiencing prolonged mechanical ventilation (PMV) as demonstrated by the initial work of the Ontario Long-Term Ventilation Strategy (LTVS).
• Recent data (i.e., since 2013) is not available to characterize patients (e.g., severity of illness and social and geographic determinants of health, mortality, associated costs, etc.) requiring PMV ( >21d) in Ontario (Hill et al., 2017).
• Updated data is needed to plan safe and equitable current and future program services and research.
• Updating PMV data that includes integration of socioeconomic position and geographic distribution a variables of interest, and exploring structural vulnerability and its relationship to critical illness survivorship answers a global call to action on health equity (Howard et al., 2022) and will aid program planning for survivors of PMV.
• Understanding the impact of socioeconomic position and geographic distribution during pandemic conditions on admission trends and survivorship can help with program planning for Ontario centers of excellence that provide acute critical care resource relief during pandemic conditions (e.g., Westpark, Michael Garron Hospital).

Primary aim:

• To descriptively update Ontario critical care PMV data

Secondary aims:

1. To examine the association between PMV (in ICU) and mortality, health care utilization and costs after critical illness.
2. To compare this data set (2013 – 2023) to published data from the previous decade (2002 – 2013)
3. To examine the correlation between demographic locality and socioeconomic status (postcode, household income quintile, education level and other publicly available status data) with relation to prevalence of PMV and outcomes of interest.