Abstract
Background: The number of children having tracheostomy and those initiated on long-term ventilation (LTV) via tracheostomy has increased in the last decade. Once medically fit, their discharge can often be delayed for multiple reasons leading to a greater cost burden to the health services.
Methods: A retrospective audit was completed for children who had tracheostomy or were initiated on LTV via tracheostomy between June 2017 -June 2019. Clinical records were reviewed for demographics, diagnosis, date first declared medically fit for discharge, reasons for delay in discharge and date of discharge. Numbers of extra bed days were quantified and additional cost was estimated.
Results: A total of 16 patients had a tracheostomy inserted at a mean age of 12.9 months, 11 were males (69%). Six children were established on LTV. The most common indication for tracheostomy was structural airway abnormalities and for LTV was severe tracheobronchomalacia. Eight patients (50%) were discharged home more than 3 months after being declared medically fit, the median delay in discharge was 87.5 days (Range 22-162.5) with increased median cost of 70000 pounds per patient (Range 18000- 130000). Reasons for discharge delays included training carers, social issues including the provision of suitable housing and arranging package of care.
Conclusion: Discharge home was delayed in a large proportion of children with tracheostomy and/or LTV due to non-medical reasons. Working closely with clinical commissioning teams and developing discharge planning pathways with the community teams, social care and housing will help in efficient discharge and reduce the duration of hospitalisations for these children.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 3114.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020