The cost of treating COPD patients with long-term oxygen therapy in a French population.

摘要: Objective In greater Paris and its surroundings (as it is in all France), oxygen home delivered by not-for-profit (NP) associations or profit-making (PM) health organizations. Both are financed the national insurance. This dual context current economic climate justify an evaluation of respiratory care for patients with COPD receiving long-term therapy (LTO). pragmatic approach identifies variables that have greatest impact on direct medical costs estimates annual cost per patient. Design Retrospective study. Setting Health insurance scheme self-employed professionals (CANAM). Patients methods Between July 1985 March 1994, 234 registered CANAM files began LTO, 24% PM sector, 76% NP mainly using concentrator (78%), mean age 74±10 years, male predominance (74%), PaO 2 56.2±10.5 mm Hg, FEV 1 /FVC 43±15%, 51% having more severe illness(es) associated. The appraisal was performed a representative sample 61 measured total resources consumption patient year (physician visits tests, drugs, physiotherapy, therapy, hospitalizations acute failure, transport costs). Results A quarter each sector did not meet LTO prescription guidelines (PaO >60 Hg). For their ambulatory lower ($4,506 vs $5,399) because they used concentrator, other being equal. amounted to $11,672 (NP sectors merged). Oxygen represented 73% cost. multiple linear regression model, hospitalization largest share cost, significantly higher when 55 Hg less ($2,287 $8,717). contrast, none covariates (age, sex, , /FVC) influenced at significant level visits, amounting $1,507. Conclusion As treatment plays important role variation costs, further studies should help better understand what real motivations choose one mode administration than another determine factors may lead physicians sometimes comply clinical guidelines.