Preschool healthcare utilisation related to home oxygen status.
OBJECTIVE
To determine, in prematurely born children who had bronchopulmonary dysplasia (BPD), if respiratory morbidity, healthcare utilisation, and cost of care during the preschool years were influenced by use of supplementary oxygen at home after discharge from the neonatal intensive care unit.


METHODS
Observational study.


METHODS
Four tertiary neonatal intensive care units.


METHODS
190 children, median gestational age 27 weeks (range 22-31), 70 of whom received supplementary oxygen when discharged home.


METHODS
Review of hospital and general practitioner records together with a parent completed respiratory questionnaire.


METHODS
Healthcare utilisation, cost of care, cough, wheeze, and use of an inhaler.


RESULTS
Seventy children had supplementary oxygen at home (home oxygen group), but only one had a continuous requirement for home oxygen beyond 2 years of age. There were no significant differences in the gestational age or birth weight of the home oxygen group compared with the rest of the cohort. However, between 2 and 4 years of age inclusive, the home oxygen group had more outpatient attendances (p = 0.0021) and specialist attendances (p = 0.0023), and, for respiratory problems, required more prescriptions (p<0.0001). Their total cost of care was higher (p<0.0001). In addition, more of the home oxygen group wheezed more than once a week (p = 0.0486) and were more likely to use an inhaler (p<0.0001).


CONCLUSIONS
Children with BPD who have supplementary oxygen at home after discharge have increased respiratory morbidity and healthcare utilisation in the preschool years.
Greenough
A
A
King's College Hospital, London SE5 9RS, UK. anne.greenough@kcl.ac.uk
Alexander
J
J
Burgess
S
S
Bytham
J
J
Chetcuti
P A J
PA
Hagan
J
J
Lenney
W
W
Melville
S
S
Shaw
N J
NJ
Boorman
J
J
Coles
S
S
Pang
F
F
Turner
J
J
D001724:Birth Weight; D001997:Bronchopulmonary Dysplasia / Q000628:therapy*; D005865:Gestational Age; D017048:Health Care Costs / Q000706:statistics & numerical data; D006296:Health Services / Q000706:statistics & numerical data*; D018575:Home Care Services, Hospital-Based / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D010102:Oxygen Inhalation Therapy / Q000706:statistics & numerical data*; D011379:Prognosis; D012120:Respiration Disorders / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology