医学
肌萎缩侧索硬化
呼吸窘迫
急诊医学
肺科医师
机械通风
物理疗法
重症监护医学
麻醉
内科学
疾病
作者
Michele Vitacca,Mara Paneroni,Debora Trainini,Luca Bianchi,Giuliano Assoni,Manuela Saleri,Sonia Gilè,João Carlos Winck,Miguel Gonçalves
出处
期刊:American Journal of Physical Medicine & Rehabilitation
[Ovid Technologies (Wolters Kluwer)]
日期:2010-04-14
卷期号:89 (5): 401-406
被引量:58
标识
DOI:10.1097/phm.0b013e3181d89760
摘要
To establish a cost-effective telephone-accessed consultation and mechanical in-exsufflation (MI-E) and manually assisted coughing, oximetry feedback program for 39 patients with amyotrophic lateral sclerosis.Rapid access to healthcare consultation and to MI-E was provided to treat episodes of distress as a result of secretion encumbrance not reversed by suctioning and associated with a decrease in oxyhemoglobin saturation (SpO(2)) baseline. Avoided hospitalizations, defined by relief of respiratory distress and return of SpO(2) baseline to >or=95% by continuous ventilator use and assisted coughing, were recorded. Patient satisfaction was queried at 6 mos, and a cost analysis was performed of continuous vs. on demand MI-E use.Thirty-nine patients made a total of 1661 calls in 7.46 +/- 5.8 mos of follow-up. Twenty-seven patients had 66 home care visits by a respiratory therapist for a total time commitment of 89.7 +/- 99.3 min/patient/mo. Twelve patients, all ventilator users, were also brought mechanical in-exsufflators for mechanically assisted coughing for 47 respiratory episodes. Thirty hospitalizations were avoided. Seventy-five percent of the patients were extremely satisfied. Mean monthly cost per patient for on-demand telephone consultation, professional home healthcare visits, and MI-E as deemed necessary was euro403 +/- euro420 or 59% less than for continuous MI-E rental. Hospitalization costs were also spared.An on-demand consult and MI-E access program can avoid hospitalizations for patients with amyotrophic lateral sclerosis with significant cost savings.
科研通智能强力驱动
Strongly Powered by AbleSci AI