31 adult patients have been treated with home mechanical ventilation. 17 were poliomyelitis patients, eight myopathies, the rest had miscellaneous diagnoses. Median duration of treatment is five years (range one month--38 years). Of the 26 patients who are still alive, ten have a tracheostomy and 16 are ventilated non-invasively. In the group with the most severe functional disability (n = 12) the median cost of home care was NOK 656,460 per year. The median cost was NOK 140,000 for the group with moderate need of home care (n = 4) and NOK 0 in the self-sufficient group (n = 10). Both the total number of patients treated with home mechanical ventilation and the fraction of patients requiring both high-cost home care and hospitalisation will increase. A new national plan is needed for organising and financing both the hospital services and health care in the community.