Chest
Volume 103, Issue 5, May 1993, Pages 1463-1469
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Clinical Investigations
Surveys of Long-term Ventilatory Support in Minnesota: 1986 and 1992

https://doi.org/10.1378/chest.103.5.1463Get rights and content

To determine the prevalence and some characteristics of persons in Minnesota receiving long-term ventilatory support (ventilator-assisted individuals [VAIs]), we conducted a survey of this population in Minnesota in 1986 and then again in 1992 by canvassing long-term care units and home medical equipment providers. The number of VAIs in 1992 was 110 percent greater than in 1986 (216 vs 103). In 1986, 81 percent of these patients received care at home; the remaining patients were supported in long-term care facilities. By 1992, the percentage had changed to 65 percent supported in the home and 35 percent in long-term care facilities. In both surveys, the largest number of VAIs were in the diagnostic categories of poliomyelitis, cervical trauma, amyotrophic lateral sclerosis (ALS), chronic obstructive pulmonary disease (COPD), and muscular dystrophy. The primary diagnoses with the greatest increase in number of patients were cervical trauma and ALS. When VAIs were categorized by age groups, there was a large increase in the proportion of patients younger than 10 years of age and older than 60 years of age. While the number of patients is small, the total resources required for care of these patients can be substantial. These data suggest that we need to monitor the number and demographic characteristics of VAIs in the United States so that appropriate policies and programs are developed to provide effective support services.

Section snippets

METHODS

For the purposes of this study, a VAI was defined as an individual outside an acute-care hospital ICU setting who was receiving ventilatory support for at least 6 h/d for a duration of at least 30 days. The type of ventilatory support included primarily positive pressure ventilators, but in a small number of patients (eight patients in 1992), ventilatory support was provided by negative pressure devices (tank respirators, cuirasses, ponchos) or by pneumobelts. Individuals receiving nasal

RESULTS

In 1986, we identified 103 individuals receiving long-term ventilatory support. By 1992, we identified 216, a 110 percent increase in the number of VAIs in Minnesota (Fig 1). During that time, the prevalence in the general population of patients receiving long-term ventilatory support in Minnesota increased from 2.4/100,000 to 4.9/100,000. The number of VAIs increased in both long-term care units and in the home (Table 2). However, the percentage of patients cared for in a long-term care

DISCUSSION

Our study, using almost identical survey methods in each year, found that the number of VAIs in Minnesota increased by 110 percent from 1986 to 1992. Assuming a similar distribution of VAIs across the US population, extrapolation of our findings in Minnesota to the US population as a whole predicts that the number of VAIs in the United States increased from 5,777 in 1986 to 12,279 in 1992. This assumption, however, may not be valid as utilization of this technology probably varies in different

REFERENCES (20)

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Supported by the Ramsey Foundation.

Manuscript received June 15; revision accepted September 16.

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