Elsevier

Respiratory Medicine

Volume 103, Issue 2, February 2009, Pages 209-215
Respiratory Medicine

A model of quality assessment in patients on long-term oxygen therapy

https://doi.org/10.1016/j.rmed.2008.09.018Get rights and content
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Summary

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, PaO2  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 PaO2 > 8 kPa on oxygen. After improvements, three criteria were fulfilled by ≥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.

Keywords

Chronic obstructive pulmonary disease
Long-term oxygen
Register
Quality
Survival

Abbreviations

COPD
chronic obstructive pulmonary disease
HMV
home mechanical ventilation
kPa
kilopascal
LTOT
long-term oxygen therapy
PaO2
arterial oxygen tension

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