HOME HOSPITAL FOR LONG TERM MECHANICALLY VENTILATED PATIENTS

长期机械通气患者的家庭医院

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Abstract

As technologically advanced respiratory care becomes increasingly available, home ventilation within the Home Hospital (HH) setting is a viable alternative to specialized long-term care facilities (LTCF) for many patients needing Persistent Mechanical Ventilation (PMV). The Jerusalem HH treats 300 medically complex patients, currently including 65 patients requiring PMV. Multidisciplinary care includes 24-hour on-call physician, logistic and respiratory backup. Between 2005 -2015 the average number of HH-PMV patients increased from 34 to 66 simultaneously, while PMV patients in LTCF declined from 94 to 72. Average annual mortality in HH versus LTCF was 14% versus 38%, and formal monthly cost of HH: LTCF was 1:4. We present data comparing PMV patients treated with HH versus LTCF, including sociodemographic characteristics, clinical parameters, mood, quality of life, caregiver stress, length of trearment, mortality rates, and costs. Our findings confirm that HH for PMV is a cost effective, feasible and safe alternative to LTCF.

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