Experience with a prolonged respiratory care unit--revisited

This article provides a review of patient care statistics for a Prolonged Respiratory Care Unit located at Bethesda Lutheran Medical Center in St. Paul, MN. This unique unit, originally reviewed in Chest, was originated to provide long-term respiratory care to patients who require extensive respiratory therapy modalities, but could not be maintained in the home or other institutional settings initially because of complications of their disease processes or because of their need for specialized care and equipment. Utilization of this cost effective unit has been beneficial to the medical community not only in the Midwest but throughout the United States. This statistical update further substantiates the need for care of patients with chronic or prolonged respiratory disease in similarly modelled units. The data present a strong argument for qualification of this unit for exemption status from DRG (diagnostic related grouping) Medicare-Medicaid reimbursement rules. An outgrowth of this unit is to provide home care service to ventilator-dependent patients and to possibly generate discussion and formulation of regional referral centers for care of patients with severe respiratory disease.