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National survey: current prevalence and characteristics of home mechanical ventilation in Hungary

BACKGROUND: Home mechanical ventilation is an established treatment for chronic respiratory failure resulting in improved survival and quality of life. Technological advancement, evolving health care reimbursement systems and newly implemented national guidelines result in increased utilization worl...

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Autores principales: Valko, Luca, Baglyas, Szabolcs, Gal, Janos, Lorx, Andras
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6282340/
https://www.ncbi.nlm.nih.gov/pubmed/30522473
http://dx.doi.org/10.1186/s12890-018-0754-x
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author Valko, Luca
Baglyas, Szabolcs
Gal, Janos
Lorx, Andras
author_facet Valko, Luca
Baglyas, Szabolcs
Gal, Janos
Lorx, Andras
author_sort Valko, Luca
collection PubMed
description BACKGROUND: Home mechanical ventilation is an established treatment for chronic respiratory failure resulting in improved survival and quality of life. Technological advancement, evolving health care reimbursement systems and newly implemented national guidelines result in increased utilization worldwide. Prevalence shows great geographical variations and data on East-Central European practice has been scarce to date. The aim of the current study was to evaluate prevalence and characteristics of home mechanical ventilation in Hungary. METHODS: We conducted a nationwide study using an online survey focusing on patients receiving ventilatory support at home. The survey focused on characterization of the site (affiliation, type), experience with home mechanical ventilation, number of patients treated, indication for home mechanical ventilation (disease type), description of home mechanical ventilation (invasive/noninvasive, ventilation hours, duration of ventilation) and description of the care provided (type of follow up visits, hospitalization need, reimbursement). RESULTS: Our survey uncovered a total of 384 patients amounting to a prevalence of 3.9/100,000 in Hungary. 10.4% of patients received invasive, while 89.6% received noninvasive ventilation. The most frequent diagnosis was central hypopnea syndromes (60%), while pulmonary (20%), neuromuscular (11%) and chest wall disorders (7%) were less frequent indications. Daily ventilation need was less than 8 h in 74.2%, between 8 and 16 h in 15.4% and more than 16 h in 10.4% of patients reported. When comparing sites with a limited (< 50 patients) versus substantial (> 50 patients) case number, we found the former had significantly higher ratio of neuromuscular conditions, were more likely to ventilate invasively, with more than 16 h/day ventilation need and were more likely to provide home visits and readmit patients (p < 0,001). CONCLUSIONS: Our results show a reasonable current estimate and characterization of home mechanical ventilation practice in Hungary. Although a growing practice can be assumed, current prevalence is still markedly reduced compared to international data reported, the duality of current data hinting to a possible gap in diagnosis and care for more dependent patients. This points to the importance of establishing home mechanical ventilation centers, where increased experience will enable state of the art care to more dependent patients as well, increasing overall prevalence. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12890-018-0754-x) contains supplementary material, which is available to authorized users.
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spelling pubmed-62823402018-12-10 National survey: current prevalence and characteristics of home mechanical ventilation in Hungary Valko, Luca Baglyas, Szabolcs Gal, Janos Lorx, Andras BMC Pulm Med Research Article BACKGROUND: Home mechanical ventilation is an established treatment for chronic respiratory failure resulting in improved survival and quality of life. Technological advancement, evolving health care reimbursement systems and newly implemented national guidelines result in increased utilization worldwide. Prevalence shows great geographical variations and data on East-Central European practice has been scarce to date. The aim of the current study was to evaluate prevalence and characteristics of home mechanical ventilation in Hungary. METHODS: We conducted a nationwide study using an online survey focusing on patients receiving ventilatory support at home. The survey focused on characterization of the site (affiliation, type), experience with home mechanical ventilation, number of patients treated, indication for home mechanical ventilation (disease type), description of home mechanical ventilation (invasive/noninvasive, ventilation hours, duration of ventilation) and description of the care provided (type of follow up visits, hospitalization need, reimbursement). RESULTS: Our survey uncovered a total of 384 patients amounting to a prevalence of 3.9/100,000 in Hungary. 10.4% of patients received invasive, while 89.6% received noninvasive ventilation. The most frequent diagnosis was central hypopnea syndromes (60%), while pulmonary (20%), neuromuscular (11%) and chest wall disorders (7%) were less frequent indications. Daily ventilation need was less than 8 h in 74.2%, between 8 and 16 h in 15.4% and more than 16 h in 10.4% of patients reported. When comparing sites with a limited (< 50 patients) versus substantial (> 50 patients) case number, we found the former had significantly higher ratio of neuromuscular conditions, were more likely to ventilate invasively, with more than 16 h/day ventilation need and were more likely to provide home visits and readmit patients (p < 0,001). CONCLUSIONS: Our results show a reasonable current estimate and characterization of home mechanical ventilation practice in Hungary. Although a growing practice can be assumed, current prevalence is still markedly reduced compared to international data reported, the duality of current data hinting to a possible gap in diagnosis and care for more dependent patients. This points to the importance of establishing home mechanical ventilation centers, where increased experience will enable state of the art care to more dependent patients as well, increasing overall prevalence. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12890-018-0754-x) contains supplementary material, which is available to authorized users. BioMed Central 2018-12-06 /pmc/articles/PMC6282340/ /pubmed/30522473 http://dx.doi.org/10.1186/s12890-018-0754-x Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Valko, Luca
Baglyas, Szabolcs
Gal, Janos
Lorx, Andras
National survey: current prevalence and characteristics of home mechanical ventilation in Hungary
title National survey: current prevalence and characteristics of home mechanical ventilation in Hungary
title_full National survey: current prevalence and characteristics of home mechanical ventilation in Hungary
title_fullStr National survey: current prevalence and characteristics of home mechanical ventilation in Hungary
title_full_unstemmed National survey: current prevalence and characteristics of home mechanical ventilation in Hungary
title_short National survey: current prevalence and characteristics of home mechanical ventilation in Hungary
title_sort national survey: current prevalence and characteristics of home mechanical ventilation in hungary
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6282340/
https://www.ncbi.nlm.nih.gov/pubmed/30522473
http://dx.doi.org/10.1186/s12890-018-0754-x
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