title: High versus restricted use of home oxygen therapy, health care utilisation and the cost of care in chronic lung disease infants.
abstract: Use of home oxygen therapy for prematurely born infants with chronic lung disease (CLD) can facilitate early discharge, but affected infants might require more readmissions. Our aim was to determine if health care utilisation and associated costs in the first 2 years were greater in centres with a high compared to centres with restricted use of home oxygen therapy. A retrospective review of the hospital and general practitioner (GP) medical records of 235 infants with CLD (median gestational age 27 weeks; range 22-33 weeks) was performed to note their readmissions, outpatient attendances, community service referrals and cost of care in the first 2 years after birth. A total of 76 infants (64%) in the high use centres and 12 (10%) in the restricted use centres were discharged home on oxygen. Infants in the high use centres were discharged home from neonatal care at a younger age (median 37.7 versus 39.9 weeks; P<0.001), but subsequently had similar numbers of inpatient events, and less GP (P =0.012) and community care (P < 0.001) contacts, although their duration of home oxygen use was longer (P < 0.001). The post-discharge costs were similar in the two types of centre, but the neonatal costs (P < 0.0001) and total cost of care per infant over the first 2 years (P < 0.0001) were lower in the high use centres.
  
  
  CONCLUSIONS
  Early discharge and high use of home oxygen therapy was not associated with an increased cost of care or increased morbidity.
authors.affiliation: Department of Child Health, King's College Hospital, SE5 9RS London, UK. anne.greenough@kcl.ac.uk
authors.forename: Anne
authors.initials: A
authors.lastname: Greenough
authors.forename: John
authors.initials: J
authors.lastname: Alexander
authors.forename: Sal
authors.initials: S
authors.lastname: Burgess
authors.forename: Phillip A J
authors.initials: PA
authors.lastname: Chetcuti
authors.forename: Sarah
authors.initials: S
authors.lastname: Cox
authors.forename: Warren
authors.initials: W
authors.lastname: Lenney
authors.forename: Francis
authors.initials: F
authors.lastname: Turnbull
authors.forename: Nigel J
authors.initials: NJ
authors.lastname: Shaw
authors.forename: Alison
authors.initials: A
authors.lastname: Woods
authors.forename: Jill
authors.initials: J
authors.lastname: Boorman
authors.forename: Stephen
authors.initials: S
authors.lastname: Coles
authors.forename: Jackie
authors.initials: J
authors.lastname: Turner
mesh_terms: D000367:Age Factors; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D002908:Chronic Disease; D003907:Dexamethasone / Q000008:administration & dosage; D017048:Health Care Costs; D015276:Health Care Rationing; D018575:Home Care Services, Hospital-Based / Q000191:economics / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008171:Lung Diseases / Q000628:therapy*; D009819:Office Visits / Q000706:statistics & numerical data; D010102:Oxygen Inhalation Therapy / Q000191:economics / Q000706:statistics & numerical data*; D010351:Patient Discharge; D012189:Retrospective Studies; D006113:United Kingdom
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone