Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.
Korean J Intern Med. 2012 Sep;27(3):311-6. doi: 10.3904/kjim.2012.27.3.311. Epub 2012 Sep 1.
BACKGROUND/AIMS: Home oxygen therapy (HOT) costs a great deal every year and demand for the service is growing. In Korea, health insurance has covered HOT since November 1, 2006. The objective of this study was to evaluate clinical features of patients who used long-term HOT due to chronic respiratory failure and to determine the appropriateness of oxygen prescriptions.
Between November 2006 and April 2010, patients prescribed long-term HOT were enrolled in the study at a tertiary university referral hospital and their medical records and telephone survey information were evaluated. In total, 340 patients were evaluated retrospectively.
Regarding the initial indications for HOT, their mean PaO(2) was 49.8 mmHg and mean SpO(2) was 82.2%. Underlying diseases included chronic obstructive pulmonary disease (COPD, 19.8%), lung cancer (12.6%), and interstitial lung disease (11.2%). The admission rate within 1 year was 53.4% and the average number of admissions was 1.64/patient. Other underlying diseases for which oxygen was prescribed, despite not meeting the insurance coverage criteria, were lung cancer (36.6%) and interstitial pneumonia (16.6%).
Home oxygen prescriptions have increased since health insurance coverage was extended. However, cases of oxygen prescriptions frequently do not meet the coverage criteria. It is important to discuss extending the coverage criteria to other disease groups, such as interstitial lung disease and lung cancer, in terms of cost-effectiveness. Further, physicians prescribing oxygen therapy should be educated regarding the criteria.
背景/目的:家庭氧疗(HOT)每年耗费巨大,且需求不断增加。在韩国,自 2006 年 11 月 1 日起,医疗保险已涵盖 HOT。本研究旨在评估因慢性呼吸衰竭而长期接受 HOT 的患者的临床特征,并确定氧气处方的适宜性。
2006 年 11 月至 2010 年 4 月,在一家三级大学附属医院,对长期接受 HOT 治疗的患者进行了研究,评估了他们的病历和电话调查信息。共回顾性评估了 340 例患者。
关于 HOT 的初始适应证,其平均 PaO₂为 49.8mmHg,平均 SpO₂为 82.2%。基础疾病包括慢性阻塞性肺疾病(COPD,19.8%)、肺癌(12.6%)和间质性肺疾病(11.2%)。1 年内的住院率为 53.4%,平均住院人数为 1.64/人。尽管不符合保险覆盖标准,但因其他基础疾病而开具氧气处方的情况还有肺癌(36.6%)和间质性肺炎(16.6%)。
自医疗保险覆盖范围扩大以来,家庭氧气处方数量有所增加。然而,氧气处方的情况经常不符合覆盖标准。从成本效益的角度来看,有必要讨论将覆盖标准扩展到其他疾病群体,如间质性肺疾病和肺癌。此外,开具氧气治疗处方的医生应接受相关标准的教育。