Goldberg A I, Frownfelter D
Northwestern University Medical School, Chicago.
Chest. 1990 Aug;98(2):428-33. doi: 10.1378/chest.98.2.428.
A paucity of reliable data exists concerning ventilator-assisted individuals (VAIs) for program planning. The Chicago Lung Association, with funding from Blue Cross/Blue Shield of Illinois, conducted a community action project to determine the magnitude of the issues in Illinois. The purposes of the VAI Study were to ascertain needs and resources, generate recommendations, and recruit community involvement. The survey identified 453 VAIs: 145 in hospitals, 105 in extended-care facilities, and 203 at home. A majority (62 percent) of hospitals provided services to VAIs; many more would with proper reimbursement incentives. Only 60 percent of hospitals serving VAIs had active discharge teams; discharge was accomplished by a variety of mechanisms and personnel. Monthly hospital charges averaged $22,190 with a range from $10,020 to $66,750 depending on the location of the patient. Most reimbursement was public; private funding was fragmented. Major discharge barriers were inadequate payment for community-based services, limited community resources, constrained consumer's finances, and lack of access to information. Recommendations for future community action included establishing a technology transfer system, home care case management, an integrated management system, a documentation center, and trials and demonstrations prior to program and policy development.
关于为制定项目计划而使用呼吸机辅助的人群（VAIs），可靠数据匮乏。在伊利诺伊州蓝十字蓝盾公司的资助下，芝加哥肺脏协会开展了一个社区行动项目，以确定伊利诺伊州这些问题的严重程度。VAIs研究的目的是确定需求和资源、提出建议并争取社区参与。该调查确定了453名VAIs：145名在医院，105名在长期护理机构，203名在家中。大多数（62%）医院为VAIs提供服务；如果有适当的报销激励措施，会有更多医院这样做。只有60%为VAIs提供服务的医院有活跃的出院团队；出院通过多种机制和人员来完成。根据患者所在地点，医院每月收费平均为22,190美元，范围从10,020美元到66,750美元不等。大多数报销是公共的；私人资金分散。主要的出院障碍包括社区服务支付不足、社区资源有限、消费者资金紧张以及获取信息困难。对未来社区行动的建议包括建立一个技术转让系统、家庭护理病例管理、一个综合管理系统、一个文献中心，以及在项目和政策制定之前进行试验和示范。
