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First experience with the home-care management system for respiratory patients in Israel
Alexander Guber1, Eyal Morris, Baruch Chen
1Department of Pulmonology, Meir Hospital, Kfar Saba, Israel. aguber@post.tau.ac.il
Background:
Ventilator-dependent patients represent an increasing clinical logistic and economic burden. An alternative solution might be monitored home care with high-tech ventilatory support systems.
Objectives:
To explore the implications of such home care management, such as its impact on quality of life and its cost-effectiveness, and to assess the practical feasibility of this mode of home care in Israel.
Methods:
We surveyed 25 partly or fully home-ventilated patients (17 males and 8 females), average age 37.6 years (range 1-72), who were treated through a home care provider during a 2 year period.
Results:
Most patients (n = 18) had a neuromuscular respiratory disorder. The average hospital stay of these patients prior to entry into the home care program was 181.2 days/per patient. The average home care duration was 404.9 days/per patient (range 60-971) with a low hospitalization rate of 3.3 +/- 6.5 days/per patient. The monthly expenditure for home care of these patients was one-third that of the hospital stay cost ($3.546.9 vs. $11.000, per patient respectively). The patients reported better quality of life in the home care environment, as assessed by the Sickness impact Profile questionnaire.
Conclusions:
Home ventilation of patients in Israel by home care providers is a practical and attractive treatment modality in terms of economic benefits and quality of life.