title: Economic cost of home-based care for ventilator-assisted individuals: a preliminary report.
abstract: OBJECTIVE
  To measure the direct and indirect costs of maintaining a ventilator-assisted individual (VAI) at home.
  
  
  METHODS
  A cross-sectional survey was conducted of primary family caregivers of VAIs residing in 37 states.
  
  
  METHODS
  Surveys were delivered to the homes of VAIs.
  
  
  METHODS
  Two hundred seventy-seven (19.7%) of 1,404 primary family caregivers of patients who were ventilator-dependent and who were living at home. Interventions. None.
  
  
  METHODS
  Participants received the modified Katz Index and an investigator-developed Home Ventilator Care Cost and Utilization Survey (HVCCUS).
  
  
  RESULTS
  Total cost of care was determined by summing total direct medical and nonmedical costs of home care and lost wages. Using LPN rates for private duty care, the average total cost of care was estimated to be $7,642 per month (median=$5,406). Using RN rates for private duty care, the average total cost of home care was estimated to be $8,596 per month (median=$5,911). Variation with VAI characteristics is discussed.
  
  
  CONCLUSIONS
  Home care of VAIs is a labor-intensive and an economically costly undertaking. The development of policies and programs to support home placement requires additional investigation regarding factors affecting the cost-effectiveness of various placement settings, as well as the ability and/or willingness of family members to accept the cost and responsibility of home care.
authors.affiliation: Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Sevick
authors.forename: M S
authors.initials: MS
authors.lastname: Kamlet
authors.forename: L A
authors.initials: LA
authors.lastname: Hoffman
authors.forename: I
authors.initials: I
authors.lastname: Rawson
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs; D006699:Home Care Services / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000191:economics*; D014481:United States