Tuberc Respir Dis.  2009 Aug;67(2):88-94.

Long-term Oxygen Therapy for Chronic Respiratory Insufficiency: the Situation in Korea after the Health Insurance Coverage: a Multi-center Korean Survey -Study for the Development and Dissemination of the COPD Guidelines, Clinical Research Center for Chronic Obstructive Airway Disease

• Park MJ
• Yoo JH
• Choi CW
• Kim YK
• Yoon HK
• Kang KH
• Lee SY
• Choi HS
• Lee KH
• Lee JH
• Lim SC
• Kim YI
• Shin DH
• Kim TH
• Jung KS
• Park YB

Abstract

BACKGROUND
From November 2006, The national health insurance system in the Republic of Korea began to cover prescribed long-term oxygen therapy (LTOT) in patients with chronic respiratory insufficiency. This study examined the current status of LTOT after national health insurance coverage. METHODS: Between November 1, 2006 and June 30, 2008, the medical records of patients who were prescribed LTOT by chest physicians were reviewed. The data was collected from 13 university hospitals. RESULTS: 197 patients (131 male and 66 female) were prescribed LTOT. The mean age was 64.3+/-13.0 years. The most common underlying disease was chronic obstructive pulmonary disease (n=103, 52.3%). Chest physicians prescribed LTOT using arterial blood gas analysis or a pulse oxymeter (74.6%), symptoms (14%), or a pulmonary function test (11.2%). The mean oxygen flow rate was 1.56+/-0.68 L/min at rest, 2.08+/-0.91 L/min during exercise or 1.51+/-0.75 L/min during sleep. Most patients (98.3%) used oxygen concentrators. Only 19% of patients used ambulatory oxygen supplies. The oxygen saturation before and after LTOT was 83.18+/-10.48% and 91.64+/-7.1%, respectively. After LTOT, dyspnea improved in 81.2% of patients. The mean duration of LTOT was 16.85+/-6.71 hours/day. The rental cost for the oxygen concentrator and related electricity charges were 48,414+/-15,618 won/month and 40,352+/-36,815 won/month, respectively. Approximately 75% of patients had a regular visit by the company. 5.8% of patients had personal pulse oxymetry. 54.9% of patients had their oxygen saturation checked on each visit hospital. 8% of patients were current smokers. The most common complaint with LTOT was the limitation of daily activity (53%). The most common complaint with oxygen concentrators was noise (41%). CONCLUSION: The patients showed good compliance with LTOT. However, only a few patients used an ambulatory oxygen device or had their oxygen saturation measured.

Keyword

Long-term home oxygen therapy; Reimbursement; Chronic respiratory insufficiency; COPD

MeSH Terms

Blood Gas Analysis
Compliance
Dyspnea
Electricity
Equipment and Supplies
Fees and Charges
Hospitals, University
Humans
Insurance, Health
Korea
Male
Medical Records
National Health Programs
Noise
Oxygen
Pulmonary Disease, Chronic Obstructive
Republic of Korea
Respiratory Function Tests
Respiratory Insufficiency
Thorax
Oxygen

Figure

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  Figure 1 Distribution of age in the study population with long-term oxygen therapy.

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  Figure 2 Changes of SaO2 before and after the use of LTOT Using the paired t-test, p<0.001. LTOT: long-term oxygen therapy.

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  Figure 3 Changes in the patients' quality of life after long-term oxygen therapy.

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  Figure 4 Total rental fee for oxygen concentrator (reimbursement rates are 96,000 won/month).

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  Figure 5 Reported complaints with regard to long-term oxygen therapy.

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