First experience with the home-care management system for respiratory patients in Israel.

BACKGROUND Ventilator-dependent patients represent an increasing clinical logistic and economic burden. An alternative solution might be monitored home care with high-tech ventilatory support systems. OBJECTIVES To explore the implications of such home care management, such as its impact on quality of life and its cost-effectiveness, and to assess the practical feasibility of this mode of home care in Israel. METHODS We surveyed 25 partly or fully home-ventilated patients (17 males and 8 females), average age 37.6 years (range 1-72), who were treated through a home care provider during a 2 year period. RESULTS Most patients (n = 18) had a neuromuscular respiratory disorder. The average hospital stay of these patients prior to entry into the home care program was 181.2 days/per patient. The average home care duration was 404.9 days/per patient (range 60-971) with a low hospitalization rate of 3.3 +/- 6.5 days/per patient. The monthly expenditure for home care of these patients was one-third that of the hospital stay cost ($3.546.9 vs. $11.000, per patient respectively). The patients reported better quality of life in the home care environment, as assessed by the Sickness impact Profile questionnaire. CONCLUSIONS Home ventilation of patients in Israel by home care providers is a practical and attractive treatment modality in terms of economic benefits and quality of life.