Morbidity and Mortality Patterns of Ventilator-Dependent Children in a Home Care Program

Abstract Background The number of technology-dependent children (TDC) is increasing in South Korea, but available healthcare services after their discharge are poor. This study aimed to examine how TDC and caregivers live at home and identify their difficulties and needs regarding home care with few services to support them. Methods This cross-sectional study was conducted in a tertiary hospital for children in South Korea. A self-reported questionnaire was completed by primary caregivers of TDC who were younger than 19 years and had been dependent on medical devices for more than 3 months. Technologies included home mechanical ventilation, oxygen supplementation, suction equipment, enteral feeding tube, and home total parenteral nutrition. Patterns of healthcare use and home care of TDC and caregivers’ perception toward child were assessed. Results A total of 74 primary caregivers of TDC completed a self-reported questionnaire. About 60% children were aged under 5 years. There were 31.1% children who required both respiratory and nutritional support. On average, caregivers took care of a child for 14.4 (±6.1) hours, slept for 5.6 (±1.6) hours, and spent 2.4 h per day on personal activities. Children used hospital services for 41.3 (±45.6) days in 6 months, and most (78.1%) were transported through private car/ambulance. Participants (75.6%) reported taking more than an hour to get to the hospital. More than 80% of caregivers responded that child care is physically very burdensome. The only statistically significant relationships was between economic status and financial burden (p = 0.026). Conclusions Caregivers of TDC reported having significant time pressure regarding childcare-related tasks, insufficient time for personal activities, and inefficient hospital use because of inadequate medical services to support them in South Korea. Thus, it is necessary to support caregivers and develop a home care model based on current medical environment.

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Nursing Service in a Home Care Program

AJN American Journal of Nursing ◽

10.2307/3458941 ◽

1951 ◽

Vol 51 (4) ◽

pp. 233 ◽

Cited By ~ 1

Author(s):

John D. Thompson

Keyword(s):

Home Care ◽

Care Program ◽

Nursing Service

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Cost Analysis of Methylprednisolone Treatment of Multiple Sclerosis Patients

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100034053 ◽

1998 ◽

Vol 25 (3) ◽

pp. 222-229 ◽

Cited By ~ 9

Author(s):

Lynda S. Robson ◽

Charlene Bain ◽

Shann Beck ◽

Suzanne Guthrie ◽

Peter C. Coyte ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cost Saving ◽

Cost Analysis ◽

Home Care ◽

Care Program ◽

Sensitivity Analyses ◽

Patient Treatment ◽

Fiscal Year ◽

Multiple Sclerosis Patients ◽

The Cost

ABSTRACT:Background:Intravenous methylprednisolone (IVMP) is the treatment of choice for multiple sclerosis (MS) patients undergoing acute exacerbation of disease symptoms and yet its cost has not been accurately determined. Determination of this cost in different settings is also pertinent to consideration of cost-saving alternatives to in-patient treatment.Methods:Cost analysis from the point of view of the health care system of IVMP treatment of MS patients receiving treatment in association with a selected Toronto teaching hospital in fiscal year 1994/95 was carried out. Costs of any concurrent treatments were excluded.Results:Total cost for 92 patients, based on a 4 dose regime, was estimated to be $78,527. The the cost per patient was $1,1181.84 for in-patients (IP), $714.64 for out-patients of the MS Clinic (OP) and $774.21 for patients whose treatment was initiated in the Clinic, but completed in the home (HC). Sensitivity analyses indicated: 1) IP treatment was in all cases more expensive than that of OP or HC; 2) the cost savings of OP vs. HC was sensitive to assumptions made regarding Clinic overhead, Clinic nursing costs and Home Care Program overhead.Conclusion:Alternatives to in-patient care must be considered carefully. In this study, both out-patient and in-home treatment were cost-saving alternatives to in-patient treatment, but large differences in the cost of hospital out-patient vs. in-home care could not be demonstrated.

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Home-care program for pre-eclampsia

Inpharma Weekly ◽

10.2165/00128413-199309180-00011 ◽

1993 ◽

Vol &NA; (918) ◽

pp. 6

Author(s):

&NA;

Keyword(s):

Home Care ◽

Care Program

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The Reform of Home Care Services in Ontario: Opportunity Lost or Lesson Learned?

Canadian Journal of Occupational Therapy ◽

10.1177/000841740707400309 ◽

2007 ◽

Vol 74 (3) ◽

pp. 208-216 ◽

Cited By ~ 1

Author(s):

Glen Randall

Keyword(s):

Home Care ◽

Physical Therapists ◽

Critical Role ◽

Care Program ◽

Home Care Services ◽

Rehabilitation Services ◽

Hospital Discharges ◽

Rehabilitation Professionals ◽

Care Services ◽

Commission Report

Background. With the release of the Romanow Commission report, Canadian governments are poised to consider the creation of a national home care program. If occupational and physical therapists are to have input in shaping such a program, they will need to learn from lost opportunities of the past. Purpose. This paper provides an overview of recent reforms to home care in Ontario with an emphasis on rehabilitation services. Method. Data were collected from documents and 28 key informant interviews with rehabilitation professionals. Results. Home care in Ontario has evolved in a piecemeal manner without rehabilitation professionals playing a prominent role in program design. Practice Implications. Rehabilitation services play a critical role in facilitating hospital discharges, minimizing readmissions, and improving the quality of peoples' lives. Canadians will benefit if occupational and physical therapists seize the unique opportunity before them to provide meaningful input into creating a national home care program.

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A PEDIATRIC HOME CARE PROGRAM IN LONDON—TEN YEARS EXPERIENCE

PEDIATRICS ◽

10.1542/peds.36.3.314 ◽

1965 ◽

Vol 36 (3) ◽

pp. 314-321

Author(s):

A. B. Bergman ◽

H. Shrand ◽

T. E. Oppé

Keyword(s):

Home Care ◽

Home Environment ◽

Hospital Costs ◽

Care Program ◽

Chronically Ill ◽

The United States ◽

Age Group ◽

Small Children ◽

Descriptive Account ◽

Sick Children

RECENT YEARS have seen a resurgence of interest in organized Home Care programs as a variety of factors have spurred the search for alternatives to hospital care. Chief among them has been the economic burden of spiraling hospital costs. Many programs have been devised to enable chronically ill persons in the older age group—the "home-bound" geriatric patient—to be supervised in their own homes. There are, however, special reasons for attempting to control the admission of children to hospitals. Illness is a time when a child becomes more dependent than usual and seems to need the security of parents and the comfort of familiar home environment. Even though enlightened hospitals now encourage visiting, many parents cannot take advantage of this for such reasons as distance and having to care for the other children at home. There is debate as to the amount of emotional harm caused by hospitalization of small children; most workers would say it does no good, and, in some cases, can lead to serious sequelae. The Home Care Program for sick children at St. Mary's Hospital in London was started in April, 1954. One of us (A.B.B.) had the opportunity of participating in this program in 1961 while serving as an Exchange Registrar from Children's Hospital (Boston). It is felt that even though conditions in the United States and Great Britain may be different, there are enough similarities to make a descriptive account of the program of interest to American physicians. The Development of Home Care Schemes Historically, doctors looked after the sick in their own homes when private fees could be afforded.

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