보험과 관련된 가정용 기계환기기의 적용에 관한 연구

Abstract

Purpose: Use of a home mechanical ventilator can shorten the hospitalization duration of children with chronic respiratory failure requiring long-term use of a mechanical ventilator. In this study, the researchers analyzed patients who had used a home mechani- cal ventilator. Methods: From January 2009 to July 2014, we retrospectively investigated 15 patients under 18 years of age, from 2 hospitals, and their use of home mechanical ventilators. Results: The median age of the patients was 55 months. Ten children were male, and 5 were female. As for the type of mechanical ventilators, 10 used a pressure type, 3 used a volume type, and 2 used a volume-mask type. Analysis of underlying diseases revealed that 10 children had neuromuscular disease, 3 had pulmonary disease, and 2 suff ered from hypoxic ischemic encephalopathy. The number of patients who were discharged from the hospital with a home mechanical ventilator was 13. One child died of sepsis irre- spective of the mechanical ventilator. Six patients had health insurance. But 9 did not. The group with insurance had the possibility of being discharged earlier than the group without. On readmission, the length of hospitalization was also reduced in patients who had used a home mechanical ventilator. Conclusion: Use of a mechanical ventilator at home is helpful in patients who need long-term use of a mechanical ventilator due to neuromuscular disease, chronic pulmonary diseases, and accidents because complications are rare and insurance coverage is feasible.