High versus restricted use of home oxygen therapy, health care utilisation and the cost of care in chronic lung disease infants

Greenough, Anne; Alexander, John R.; Burgess, S; Chetcuti, Philip; Cox, Sarah; Lenney, Warren; Turnbull, F; Shaw, N J; Woods, A.E; Boorman, J; Coles, Stephen J.; Turner, Jackie

doi:10.1007/s00431-004-1415-z

Cited by 34 publications

(28 citation statements)

References 11 publications

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“…No entanto, o custo total se mostrou significativamente maior no serviço com menor frequência de indicação da ODP devido aos gastos com internações mais prolongadas 7 .…”

Section: Em Dezembro De 2008 O Banco De Dados Da Britishunclassified

“…Essa modalidade terapêutica vem sendo utilizada com maior frequência em diversas doenças pulmonares crônicas, na faixa etária pediátrica, com o intuito de reduzir a morbidade e melhorar a qualidade de vida dos pacientes [2][3][4][5] . Essa prática permite otimizar a ocupação dos leitos, reduzir o período e o número de internações e, consequentemente, diminuir custos hospitalares [4][5][6][7][8] .…”

Section: Introductionunclassified

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Long-term home oxygen therapy in children and adolescents: analysis of clinical use and costs of a home care program

Munhoz¹,

Adde²,

Nakaie³

et al. 2010

J Pediatr (Rio J)

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Objectives: To describe the clinical and laboratory characteristics of patients on long-term home oxygen therapy followed up by the home care program of Hospital das Clínicas, School of Medicine, Universidade de São Paulo, during a period of 8 years, and to compare groups with and without secondary pulmonary hypertension. To estimate the cost of the program using oxygen concentrators versus oxygen cylinders provided by the hospital. Methods:A descriptive, retrospective cohort study of patients on long-term home oxygen therapy followed up from 2002 to 2009 at the Unit of Pulmonology, Children's Institute, Hospital das Clínicas, School of Medicine, Universidade de São Paulo. Results:We studied 165 patients, of whom 53% were male, with the following medians: age at the beginning of oxygen therapy -3.6 years; duration of oxygen therapy -7 years; and survival time after beginning of oxygen therapy -3.4 years. The main diagnoses were: cystic fibrosis (22%), bronchopulmonary dysplasia (19%), and bronchiolitis obliterans (15%). Of the 33 patients who underwent spirometry, 70% had severe obstructive lung disease. Echocardiogram was performed in 134 patients; 51% of them had secondary pulmonary hypertension. There was a statistically significant association between pulmonary hypertension and need of higher oxygen flows (chi-square, p = 0.011), and pulmonary hypertension and longer duration of oxygen therapy (Logrank, p = 0.0001). There was no statistically significant difference between survival time after the beginning of oxygen therapy and pulmonary hypertension. The average monthly costs of the program were: US$ 7,392.93 for concentrators and US$ 16,630.92 for cylinders.Conclusions: Long-term home oxygen therapy was used to treat different chronic diseases, predominantly in infants and preschool children. There was a high frequency of pulmonary hypertension associated with longer periods of oxygen use and greater oxygen flow, without association with survival rate. The use of concentrators instead of cylinders may reduce costs significantly. Resultados: Foram estudados 165 pacientes, 53% do sexo masculino, com as medianas: idade de início da oxigenoterapia -3,6 anos; tempo de oxigenoterapia -7 anos; e tempo de sobrevida após início da oxigenoterapia -3,4 anos. Os principais diagnósticos foram: fibrose cística (22%), displasia broncopulmonar (19%) e bronquiolite obliterante (15%). Dos 33 pacientes que realizaram espirometria, 70% apresentavam distúrbio ventilatório obstrutivo grave. O exame ecocardiográfico foi executado em 134 pacientes; 51% deles tinham hipertensão pulmonar secundária. Houve associação estatisticamente significante entre: presença de hipertensão pulmonar e necessidade de maiores fluxos de oxigênio (qui-quadrado, p = 0,011); e presença de hipertensão pulmonar e maior tempo de oxigenoterapia (Logrank, p = 0,0001). Não houve diferença estatisticamente significante entre tempo de sobrevida após início da oxigenoterapia e presença de hipertensão pulmonar. Os custos médios mensais do programa foram:...

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“…No entanto, o custo total se mostrou significativamente maior no serviço com menor frequência de indicação da ODP devido aos gastos com internações mais prolongadas 7 .…”

Section: Em Dezembro De 2008 O Banco De Dados Da Britishunclassified

Section: Introductionunclassified

Long-term home oxygen therapy in children and adolescents: analysis of clinical use and costs of a home care program

Munhoz¹,

Adde²,

Nakaie³

et al. 2010

J Pediatr (Rio J)

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“…9 A utilização de oxigénio domiciliário favorece redução dos custos hospitalares, alta precoce e a redução da infeção associada aos cuidados de saúde. 10 A complexidade e especificidade da prescrição pediátrica de OLD, a amplitude de doenças candidatas e os custos associados, determinam a necessidade de coordenação de cuidados em centros de referência.…”

Section: Introductionunclassified

Oxigenoterapia Domiciliária de Longa Duração na Criança: Evidências e Questões em Aberto

et al. 2014

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Introduction: Long-term home oxygen therapy is indicated for patients with chronic hypoxemia. We intend to describe pediatric population on long-term home oxygen therapy followed-up at Pediatric Respiratory Unit of a tertiary care hospital between 2003-2012 and to compare with previous 1991-2000 review; to verify conformity with international and national recommendations and need for specific pediatric national guidelines, non-existent in Portugal. Material and Methods: Retrospective, descriptive and comparative study based on clinical files review. Review the guidelines for oxygen therapy in pediatric population. Results: We studied 86 patients (59.3% males). The median age at the beginning of oxygen therapy was 0.0 (0.0-216.0) months, with a median duration of 15.0 (3.0-223.0) months. The most frequent diagnosis was bronchopulmonary dysplasia (53.5%), followed by bronchiolitis obliterans (14.0%), neurologic disorders (10.5%), cystic fibrosis (8.1%), miscellaneous syndromes (5.8%), sickle-cell disease (3.5%), other neonatal lung diseases (2.3%) and interstitial lung diseases (2.3%). Are maintained on follow-up 53 (61.6%) patients, 38 on oxygen therapy; 12 (13.9%) died. The median time of follow-up was 39.5 (1.0-246.0) months, minim on other neonatal lung diseases and maximum on cystic fibrosis. Comparing with previous review, this shows a relative increase in bronchiolitis obliterans and bronchopulmonary dysplasia patients, with increased duration in the latter, and inclusion of neurologic and hematologic patients. Discussion: Prescription of long-term oxygen therapy in pediatric age mainly occurs in specific diseases of infants and pre-school aged. Neurologic and hematologic patients represent new indications, similarly to international publications. Conclusion: The knowledge of national reality and pediatric orientations are needed for care plans and rational prescription. Keywords: Child; Long-Term Care; Respiratory Insufficiency; Oxygen Inhalation Therapy; Portugal.

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“…The device for administration of O 2 consisted of a nasal cannula (87%), and the system provider was the O 2 concentrator (58% [5][6][7][8] . Esta prática permite otimizar a ocupação dos leitos, reduzir o período e o número de internações e, consequentemente, os custos hospitalares [7][8][9][10][11] .…”

Section: Lista De Abreviaturas E Siglasunclassified

“…A redução do tempo de hospitalização minimiza o risco de infecção hospitalar e proporciona também uma maior interação do paciente com a família 10,12 .…”

Section: Lista De Abreviaturas E Siglasunclassified

Aspectos clínicos, laboratoriais e de custos da população de crianças e adolescentes em oxigenoterapia domiciliar acompanhados pelo Instituto da Criança HC-FMUSP

Munhoz¹

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High versus restricted use of home oxygen therapy, health care utilisation and the cost of care in chronic lung disease infants

Abstract: Early discharge and high use of home oxygen therapy was not associated with an increased cost of care or increased morbidity.

Cited by 34 publications

References 11 publications

Long-term home oxygen therapy in children and adolescents: analysis of clinical use and costs of a home care program

Long-term home oxygen therapy in children and adolescents: analysis of clinical use and costs of a home care program

Oxigenoterapia Domiciliária de Longa Duração na Criança: Evidências e Questões em Aberto

Aspectos clínicos, laboratoriais e de custos da população de crianças e adolescentes em oxigenoterapia domiciliar acompanhados pelo Instituto da Criança HC-FMUSP

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