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(Chest. 1996;109:1597-1606.)
© 1996 American College of Chest Physicians

Economic Cost of Home-Based Care for Ventilator-Assisted Individuals

A Preliminary Report

Mary Ann Sevick ScD, RN1; Mark S. Kamlet PhD2; Leslie A. Hoffman PhD, RN3; and Ian Rawson PhD4

1 From the Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC
2 From The H. John Heinz III School of Public Policy and Management, Carnegie Mellon University, Pittsburgh
3 From the School of Nursing, University of Pittsburgh
4 From The H. John Heinz III School of Public Policy and Management, Carnegie Mellon University, Pittsburgh; and the Allegheny General Hospital, Pittsburgh

Study objective: To measure the direct and indirect costs of maintaining a ventilator-assisted individual (VAI) at home.

Design: A cross-sectional survey was conducted of primary family caregivers of VAIs residing in 37 states.

Setting: Surveys were delivered to the homes of VAIs.

Participants: Two hundred seventy-seven (19.7%) of 1,404 primary family caregivers of patients who were ventilator-dependent and who were living at home.

Interventions: None.

Measures: Participants received the modified Katz Index and an investigator-developed Home Ventilator Care Cost and Utilization Survey (HVCCUS).

Results: Total cost of care was determined by summing total direct medical and nonmedical costs of home care and lost wages. Using LPN rates for private duty care, the average total cost of care was estimated to be $7,642 per month (median=$5,406). Using RN rates for private duty care, the average total cost of home care was estimated to be $8,596 per month (median=$5,911). Variation with VAI characteristics is discussed.

Conclusions: Home care of VAIs is a labor-intensive and an economically costly undertaking. The development of policies and programs to support home placement requires additional investigation regarding factors affecting the cost-effectiveness of various placement settings, as well as the ability and/or willingness of family members to accept the cost and responsibility of home care.

Submitted on May 16, 1995
Accepted on December 7, 2007




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