Recent trends in the use of domiciliary oxygen in England and Wales

The volume of oxygen supplied to patients at home increased four-fold in the period 1982-89, largely due to the availability of oxygen concentrators on prescription since 1985. By 1989, health service expenditure on domiciliary oxygen reached 18 pounds million. Most users of long-term oxygen therapy suffer from chronic obstructive pulmonary disease, and many patients, eligible in terms of Department of Health and Social Security guidelines to receive long-term oxygen treatment, do not do so. However, the majority of those who receive oxygen, do so in amounts and for periods of the day which are below the levels known to prolong life or improve psychosocial functioning. A consensus of clinical opinion about the use of long-term oxygen therapy is needed. Without it, the use of this expensive service cannot be meaningfully audited.