Domiciliary oxygen: rationalization of supply in the Hunter region from 1982-1986.

In October 1982, a clinic was planned at The Royal Newcastle Hospital to review the usage of domiciliary oxygen that was funded by the Provision of Aids for Disabled Persons scheme in the Hunter Region of New South Wales. Patient review included an assessment of the indications for domiciliary oxygen, education in the use of oxygen, the efficiency of delivery arrangements and the transfer from cylinders to concentrators as indicated. Between January and June 1983, 111 patients who were receiving oxygen at home were reviewed: 84 (76%) of these patients had chronic obstructive pulmonary disease; their two-year survival was 80% (95% confidence interval, 69%-87%) and five-year survival was 36% (95% confidence interval, 25%-46%). In 66 (59%) patients, review led to a reduction in the usage of domiciliary oxygen which was estimated to save $40,000 each year in the Hunter Region. In the year from 1985-1986 the decrease in the usage of oxygen at home represented an actual cost saving of $60,000 for the region ($470 per person) which translated into a saving of $95,000 ($740 per person) when inflation was taken into account. If our experience is projected nation-wide, the potential exists for a considerable cost saving by means of programmes to rationalize the use of domiciliary oxygen.