title: Domiciliary oxygen therapy services in Tasmania: prescription, usage and impact of a specialist clinic.
abstract: OBJECTIVE
  To assess the use of domiciliary oxygen therapy (DOT) in Tasmania and the impact of a specialist oxygen clinic on service provision.
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  Patients prescribed government-funded DOT in Tasmania between December 2002 and April 2004.
  
  
  METHODS
  Indications for DOT; usage, prescription, reassessment and costs of DOT; influence of a specialist-run oxygen clinic.
  
  
  RESULTS
  490 patients were using DOT, an overall rate of 102 patients per 100 000 population (varying between regions from 95 to 116 per 100 000 population). Of 267 patients (54%) prescribed DOT during hospitalisation, only 72% met national guidelines for DOT at commencement. Chronic obstructive pulmonary disease (COPD) was the most common indication (48% of prescriptions). The median time to reassessment after prescription was 5.5 months. Median usage in patients with COPD was 18.3 hours per day. The average cost per patient was $1498 per year, but differed regionally in relation to costs of ambulatory supplies. The oxygen clinic in the north-west region substantially reduced oxygen prescriptions, improved compliance with guidelines, decreased time to first reassessment from 21 to 6.6 months, and produced major cost savings.
  
  
  CONCLUSIONS
  Prescription of DOT was often not in keeping with national guidelines. Reassessment was poor, despite more than half the patients being prescribed DOT as an inpatient. A dedicated oxygen clinic resulted in more appropriate prescription, decreased time to reassessment and a reduction in costs.
authors.affiliation: University of Tasmania, Hobart, TAS, Australia. Richard.WoodBaker@utas.edu.au
authors.forename: Andrew
authors.initials: A
authors.lastname: Jones
authors.forename: Richard
authors.initials: R
authors.lastname: Wood-Baker
authors.forename: E Haydn
authors.initials: EH
authors.lastname: Walters
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy / Q000191:economics / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D012189:Retrospective Studies; D013648:Tasmania