Format

Send to

Choose Destination
Respir Med. 2007 Jun;101(6):1177-82. Epub 2006 Dec 22.

Non-invasive home mechanical ventilation: effectiveness and efficiency of an outpatient initiation protocol compared with the standard in-hospital model.

Author information

1
Servei de Pneumologia, Corporació Parc Taulí, Institut Universitari Parc Taulí, Departament de Medicina, Universitat Autònoma de Barcelona (Bellaterra), Parc Taulí s/n, 08208 Sabadell, Spain.

Abstract

OBJECTIVE:

To compare the effectiveness and efficiency of an initiation protocol for non-invasive home mechanical ventilation (NIHMV) carried out at a pulmonary outpatient clinic with the standard in-hospital model.

METHODS:

Prospective, observational study.

POPULATION:

16 patients divided into two groups: (A) outpatient protocol (n=9); and (B) standard in-hospital initiation with an elective admission (n=7).

INSTRUMENTATION:

at baseline condition and treatment starting, arterial blood gases and nocturnal pulse-oximetry were performed. At the end of follow-up, arterial blood gases and patient compliance (ventilator's built-in counter) was determined. Efficiency was evaluated by calculating cost savings per ventilated patient for the financier and accumulated days of hospitalization saved.

RESULTS:

No differences in baseline conditions were observed. Ventilation was effective in the two groups: a significant decrease in PaCO(2) and an increase in mean nocturnal oxygen saturation were observed after initiating ventilation. (Group A: PaCO(2):42.9+/-1.5; SpO(2):91.9+/-1.9; Group B:PaCO(2):44.3+/-6; SpO(2):91.9+/-2.7). At three months the effectiveness of ventilation and the number of hours of ventilation was equivalent in all groups. The new model cut costs for the health care financier by 50%. The outpatient sessions saved 63 days of hospitalization.

CONCLUSIONS:

(1) Outpatient initiation is an effective and efficient alternative to the traditional in-hospital method for NIHMV. (2) The outpatient protocol represents a substantial saving for the financier.

PMID:
17188485
DOI:
10.1016/j.rmed.2006.11.006
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center