Clinical Faculty of the Division of Pulmonary/Critical Care, University of Colorado Health Sciences Center, Denver, CO.
National Association for Medical Direction of Respiratory Care, Vienna, VA.
Chest. 2011 Feb;139(2):430-434. doi: 10.1378/chest.10-0242.
This article provides an overview of the status of long-term oxygen therapy (LTOT). In the United States, payment cutbacks are occurring as a result of congressionally mandated competitive bidding and capped rental programs. These Medicare programs are discussed. These legislative and regulatory changes may result in reduced patient access to appropriate oxygen-delivery systems that meet medical needs, including optimal ambulation. Prescribing LTOT is addressed in this article, as is the need for adequate patient education. The importance of appropriate monitoring and reassessment is presented. The use of an LTOT collaborative care model is discussed. Although the new intermittent flow oxygen-delivery systems have potential benefits, there is consensus that each patient should be tested on the specific device because of variability in delivery and patient response. Feasible locations for patient education and monitoring are identified.
这篇文章概述了长期氧疗（LTOT）的现状。在美国，由于国会授权的竞争性招标和租金上限计划，正在削减支付。讨论了这些医疗保险计划。这些立法和监管的变化可能会导致患者获得符合医疗需求的适当供氧系统的机会减少，包括最佳的活动能力。本文讨论了 LTOT 的处方问题，以及对充分的患者教育的需求。还介绍了适当监测和重新评估的重要性。讨论了 LTOT 协作护理模式的使用。尽管新型间歇流量供氧系统具有潜在的益处，但共识是，由于输送和患者反应的可变性，每个患者都应该在特定设备上进行测试。确定了患者教育和监测的可行地点。
