A model of quality assessment in patients on long-term oxygen therapy.
BACKGROUND
The difficulty of implementing guidelines for long-term oxygen therapy (LTOT) has been recognized. We performed this analysis to evaluate the impact of a national quality assurance register on the quality of LTOT and to suggest indicators with levels for excellent quality LTOT.


METHODS
Based on national register data on Swedish LTOT patients in 1987-2005, we measured nine quality indicators and the achievement levels of the participating counties in fulfilling these treatment criteria.


RESULTS
There were improvements in the following eight quality indicators: access to LTOT, PaO(2) < or = 7.3 kPa without oxygen, no current smoking, low number of thoracic deformity patients without concomitant home mechanical ventilation, >16 h of oxygen/day, mobile oxygen equipment, reassessment of hypoxemia when LTOT was not started in a stable state of chronic obstructive pulmonary disease (COPD) and avoidance of continuous oral glucocorticosteroids in COPD. There was decline in the quality indicator PaO(2) > 8 kPa on oxygen. After improvements, three criteria were fulfilled by > or = 80% of the counties in 2004-2005.


CONCLUSIONS
We found improvements in eight of nine quality indicators. We suggest these indicators with levels for excellent quality for use in quality assurance of LTOT based on our results.
Gustafson
Torbjörn
T
Department of Medicine, Skellefteå Hospital, SE-931 86 Skellefteå, Sweden. torbjorn.gustafson@lung.umu.se
Löfdahl
Kerstin
K
Ström
Kerstin
K
D000328:Adult; D019985:Benchmarking / Q000592:standards*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000379:methods / Q000592:standards*; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D019984:Quality Indicators, Health Care / Q000592:standards*; D011788:Quality of Life / Q000523:psychology; D012042:Registries; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology