Abstract
The home oxygen assessment and review (HOS-AR) team at UHCW offer an inpatient referral service for patients considered to require oxygen prior to discharge from hospital. It is widely recognised that non-specialist assessment for home oxygen results in inappropriate prescription of oxygen and ultimately increased costs. By centralising all oxygen ordering across the hospital we aimed to improve the ordering of discharge oxygen.
During 2014 there were 366 requests for discharge home oxygen. Of these 217 (59%) were for long term oxygen therapy (LTOT), 29 (8%) were for ambulatory oxygen therapy (AOT) and 120 (33%) were for palliative oxygen.
236/366 (64%) of patients referred were considered suitable for supplemental oxygen by the HOSAR team, however in 18% of these the requested oxygen flow rate was not optimal and required titrating.
36% (130) of referrals were inappropriate due to: patient already on home oxygen; patient did not fulfil criteria for supplemental oxygen; patient not medically fit for discharge or care package not in place. Ordering of LTOT alone for these patients would have cost in excess of £18,500.00. Results suggest that the HOS-AR inpatient service identifies inappropriate referrals for home oxygen which has a significant cost saving to the health economy.
Careful planning of discharge also enables routine oxygen ordering rather than urgent, four hourly supply which is more costly. 34% of orders were sent as standard (within 3 days) compared to 44% within four hours. This suggests that further work is required to improve the recognition of the potential requirement for home oxygen enabling assessment to commence earlier.
- Copyright ©the authors 2016