Surveys of long-term ventilatory support in Minnesota: 1986 and 1992

To determine the prevalence and some characteristics of persons in Minnesota receiving long-term ventilatory support (ventilator-assisted individuals [VAIs]), we conducted a survey of this population in Minnesota in 1986 and then again in 1992 by canvassing long-term care units and home medical equipment providers. The number of VAIs in 1992 was 110 percent greater than in 1986 (216 vs 103). In 1986, 81 percent of these patients received care at home; the remaining patients were supported in long-term care facilities. By 1992, the percentage had changed to 65 percent supported in the home and 35 percent in long-term care facilities. In both surveys, the largest number of VAIs were in the diagnostic categories of poliomyelitis, cervical trauma, amyotrophic lateral sclerosis (ALS), chronic obstructive pulmonary disease (COPD), and muscular dystrophy. The primary diagnoses with the greatest increase in number of patients were cervical trauma and ALS. When VAIs were categorized by age groups, there was a large increase in the proportion of patients younger than 10 years of age and older than 60 years of age. While the number of patients is small, the total resources required for care of these patients can be substantial. These data suggest that we need to monitor the number and demographic characteristics of VAIs in the United States so that appropriate policies and programs are developed to provide effective support services.