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Updated: Aug 8, 2026
Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
Preschool healthcare utilisation related to home oxygen status
A Greenough1, J Alexander, S Burgess
1King's College Hospital, London SE5 9RS, UK. anne.greenough@kcl.ac.uk
Insights
Premature infants with bronchopulmonary dysplasia (BPD) receiving home oxygen therapy experienced increased respiratory issues and higher healthcare use in preschool years. This highlights the long-term impact of early respiratory support on vulnerable children.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Health Services Research
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting prematurely born infants.
- Home oxygen therapy is sometimes prescribed after neonatal intensive care unit (NICU) discharge for infants with BPD.
- The long-term impact of home oxygen use on respiratory morbidity and healthcare utilization in preschool children with BPD is not fully understood.
Purpose of the Study:
- To investigate the association between home oxygen use after NICU discharge and respiratory morbidity, healthcare utilization, and cost of care in preschool-aged children with BPD.
Main Methods:
- An observational study was conducted across four tertiary NICUs.
- 190 prematurely born children (median gestational age 27 weeks) with BPD were included.
- Data were collected through medical record reviews and parent-completed respiratory questionnaires for 70 children who received home oxygen.
Main Results:
- Children receiving home oxygen showed significantly higher rates of outpatient and specialist attendances between ages 2 and 4.
- The home oxygen group required more respiratory prescriptions and incurred higher total healthcare costs.
- Increased weekly wheezing and greater inhaler use were also observed in the home oxygen group.
Conclusions:
- Home oxygen use in preschool children with BPD is linked to increased respiratory problems.
- These children exhibit greater healthcare utilization and associated costs.
- Findings suggest a need for careful monitoring and management of BPD patients on home oxygen therapy.
Objective:
To determine, in prematurely born children who had bronchopulmonary dysplasia (BPD), if respiratory morbidity, healthcare utilisation, and cost of care during the preschool years were influenced by use of supplementary oxygen at home after discharge from the neonatal intensive care unit.
Design:
Observational study.
Setting:
Four tertiary neonatal intensive care units.
Patients:
190 children, median gestational age 27 weeks (range 22-31), 70 of whom received supplementary oxygen when discharged home.
Interventions:
Review of hospital and general practitioner records together with a parent completed respiratory questionnaire.
Main Outcome Measures:
Healthcare utilisation, cost of care, cough, wheeze, and use of an inhaler.
Results:
Seventy children had supplementary oxygen at home (home oxygen group), but only one had a continuous requirement for home oxygen beyond 2 years of age. There were no significant differences in the gestational age or birth weight of the home oxygen group compared with the rest of the cohort. However, between 2 and 4 years of age inclusive, the home oxygen group had more outpatient attendances (p = 0.0021) and specialist attendances (p = 0.0023), and, for respiratory problems, required more prescriptions (p<0.0001). Their total cost of care was higher (p<0.0001). In addition, more of the home oxygen group wheezed more than once a week (p = 0.0486) and were more likely to use an inhaler (p<0.0001).
Conclusions:
Children with BPD who have supplementary oxygen at home after discharge have increased respiratory morbidity and healthcare utilisation in the preschool years.
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