Survey of Current Status of the Patients with Home Ventilator in Seoul and Kyunggi Province

Ahn, Jong Joon; Lee, Ki Man; Shim, Tae Sun; Lim, Chae Man; Lee, Sang Do; Kim, Woo Sung; Kim, Dong Soon; Kim, Won Dong; Koh, Youn Suck

Abstract

BACKGROUND
Home ventilation can decrease hospital-acquired infection, increase physical activity, improve nutritional status, enhance quality of life, and reduce medical costs. The number of patient using home ventilators has been increasing, particularly in Europe and United States. Although the number of patients with home ventilation has been increasing in Korea, the current status of these patients is not well known. This study was undertaken to obtain basic information upon these patients in additon to evaluating any problems related to patients' home care in our country.
METHODS
A register of 92 patients with home ventilators in Seoul and Kyunggi province were obtained from commercial ventilator supply companies. The patients were contacted by phone and 29 of them accepted our visit. Information concerning education about home care before discharge, equipment cost, and problems related to home care were documented. The mode and preset variables of the home ventilator were checked; tidal volume (TV), peak airway pressure, and oxygen saturation were measured.
RESULTS
There were 26 males (90%) and their mean age was 48.0(±20.1 years. The underlying diseases were: 21 neuromuscular disorders, 2 spinal cord injuries, 6 chronic lung diseases. Among the caregivers, spouses (n=14) predominated. Education for home care before discharge was performed primarily by intensive care unit nurses and the education for ventilator management by commercial companies. Twenty-five of the 29 patients had tracheostomies. Volume targeted type (VTT;n=20, 69%) was more frequently used than the pressure targeted type(PTT). Twenty-three of the 29 patients purchased a ventilator privately, which cost 7,450,000(±3,290,000) won for a PTT, and 14,280,000(±3,130,000) won for a VTT. Total cost for the equipment was 11,430,000(±634,000) won. The average cost required for home care per month was 1,120,000(±1,360,000) won.
CONCLUSION
The commonest underlying disease of the patients was neuromuscular disease. The VTT ventilator was primarily used with tracheostomy. Patients and their families considered the financial difficulties associated with purchasing and maintaining equipment for home care an urgent problem. Some patients were aided by a visiting nurse, however most patients were neglected and left without professional medical supervision.