A 10-year report of patients in a prolonged respiratory care unit

The author statistically analyzes 542 patients who were hospitalized in the Prolonged Respiratory Care Unit of Bethesda Lutheran Medical Center in St. Paul, Minnesota, between 1979 and 1989. A demographic description of the patients, an analysis of discharge status, and a discussion of reimbursement for care are presented. It is apparent from this analysis that: 1) there is a large number of patients who will require chronic ventilator support, 2) weaning of "unweanable" patients can occur in selected cases and can be most expeditiously accomplished in specialized units, 3) these specialized units are cost effective, and early transfer from the DRG-reimbursed ICUs would benefit not only the patient but also the reimbursing agent and referral hospital, 4) specialized, adequately funded centers for unweanable patients need to be developed, and 5) further studies and education concerning the imprudent use of ventilators must be implemented by the appropriate physician organizations.