Growth of home respiratory equipment from 2006 to 2019 and cost control by health policies

Respir Med Res. 2022 Nov:82:100930. doi: 10.1016/j.resmer.2022.100930. Epub 2022 Jun 11.

Abstract

Background: Home respiratory equipment (HRE) designed for the management of chronic respiratory failure includes oxygen therapy (O2), noninvasive ventilation (NIV) and mechanical insufflation-exsufflation (MI-E). The growth of the number of patients treated by HRE, the prevalence and the associated costs in France have not been determined.

Methods: The French open access national health insurance aggregated data was used to estimate the evolution of theses parameters from 2006 to 2019.

Results: The number of patients treated by HRE increased by 117% between 2006 and 2019, reaching a total of 245,896 patients (367/100,000). Prescriptions for O2, NIV, and MI-E increased by 88%, 189% and 162%, respectively. In 2019, 139,323 patients received long-term home O2 alone (208/100,000) with a 13% decrease for liquid O2 compared to a 44% increase for O2 concentrator. The number of patients treated by portable oxygen concentrator increased by 509% over the last 5 years. In 2019, 96,126 patients received NIV (144/100,000) and 97% of these patients were treated by NIV for less than 12 h/day. A total of 9,158 patients were treated by MI-E in 2019 (13.6/100,000). Despite the global increase in the number of patients, health costs decreased from 9% to 8% of total medical device spending in 2019 due to adjustment of health policies, such as a reduction of reimbursement rates.

Conclusion: Our results highlighted the high rate of HRE prescription, but with cost control as a result of adapted health policies.

Keywords: Chronic respiratory failure; Epidemiology; Home respiratory equipment; Noninvasive ventilation; Oxygen therapy.

MeSH terms

  • Cost Control
  • Health Policy
  • Humans
  • Noninvasive Ventilation* / methods
  • Oxygen
  • Respiratory Insufficiency* / epidemiology
  • Respiratory Insufficiency* / therapy

Substances

  • Oxygen