Building a home ventilation programme: population, equipment, delivery and cost

Area of Science:

• Medical Science
• Public Health
• Health Economics

Background:

• Home mechanical ventilation (HMV) is crucial for quality of life and survival in patients with neuromuscular disorders (NMD).
• Developing countries require evidence on HMV prevalence, costs, and organization to implement local programs.
• Existing literature on HMV in NMD is fragmented, hindering program development in resource-limited settings.

Purpose of the Study:

• To review and synthesize current evidence on HMV for NMD patients globally.
• To provide updated data on HMV prevalence, equipment costs, technical issues, and organizational aspects.
• To inform the development of sustainable HMV programs in developing countries.

Main Methods:

• A narrative review of Medline-indexed publications in English and French from 2005 to 2020.
• Analysis of 24 international HMV programs for patients with NMD.
• Data extraction on prevalence, cost, ventilation patterns, and program implementation.

Main Results:

• Estimated HMV prevalence is 7.3/100,000 population, correlating with GDP per capita.
• NMD affects ~30/100,000 population, with ~10% utilizing HMV.
• Annual equipment costs are ~168€/patient, rising to 3232-5760€/patient/year with services and maintenance.
• Nocturnal, discontinuous, and continuous ventilation use is approximately 60%, 20%, and 20% respectively.

Conclusions:

• International cooperation is vital for emerging HMV programs in developing nations.
• Updated data on HMV prevalence, costs, and technicalities can facilitate stakeholder dialogue.
• This review aims to support the creation of practical strategies for HMV implementation in NMD patients in developing countries.