Cost and physician effort analysis of invasive vs. noninvasive respiratory management of Duchenne muscular dystrophy

American Journal of Physical Medicine & Rehabilitation
John Robert BachSarah Durante

Abstract

Continuous tracheostomy mechanical ventilation users with Duchenne muscular dystrophy are institutionalized or have home nursing services (licensed practical nurse/registered nurse), whereas patients dependent on continuous noninvasive ventilatory support (CNVS) can avoid hospitalizations and publically paid services. This is a retrospective analysis comparing cost and physician effort for managing CNVS and continuous tracheostomy mechanical ventilation users with Duchenne muscular dystrophy. Compared with ongoing personal care, physician services and intercurrent hospitalization costs were negligible. Ten home continuous tracheostomy mechanical ventilation users had 16.4 hrs per day of licensed practical nurse/registered nurse care costing $269,370 per year; 14 were institutionalized at $237,350 per year; and 8 were decannulated to CNVS, with 5 subsequently returning home, costing only $9,800 per year for respiratory equipment. For 93 CNVS users, costs ranged from $9,800 per year for 37 without publically funded assistance, $44,968 per year for 3 with nurses' aides, $81,395 per year for 35 with unskilled personal assistance services, and $239,805 per year for 12 with licensed practical nurses/registered nurses. Twenty-eight be...Continue Reading

References

Feb 1, 1991·American Journal of Physical Medicine & Rehabilitation·J R Bach
May 23, 2000·American Journal of Physical Medicine & Rehabilitation·S W Kang, J R Bach
Jul 14, 2000·Chest·S W Kang, J R Bach
May 23, 2002·American Journal of Physical Medicine & Rehabilitation·Elia Gomez-Merino, John R Bach
Apr 7, 2007·American Journal of Physical Medicine & Rehabilitation·John R BachGiorgio Felisari
Dec 31, 2009·Chest·John Robert BachJoao Carlos Winck
Dec 15, 2010·Neuromuscular Disorders : NMD·Yuka IshikawaRyoji Minami
Feb 22, 2011·Respiratory Care·John R Bach, Daniel Martinez
May 10, 2011·American Journal of Physical Medicine & Rehabilitation·John Robert Bach, Maria Chiara Tuccio
Sep 9, 2011·American Journal of Physical Medicine & Rehabilitation·John Robert Bach, Anthony Decicco
Oct 12, 2012·American Journal of Physical Medicine & Rehabilitation·John R BachMarie Eugenia Dominguez
Mar 5, 2013·Canadian Respiratory Journal : Journal of the Canadian Thoracic Society·Doug A McKimJudy King

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Citations

Mar 12, 2016·Journal of Pediatric Rehabilitation Medicine·John Robert BachMichael Chiou
Mar 17, 2015·PM & R : the Journal of Injury, Function, and Rehabilitation·John R Bach, Selorm L Takyi
Jul 3, 2015·American Journal of Physical Medicine & Rehabilitation·John R Bach, Louis Ralph Saporito
Jul 16, 2019·American Journal of Speech-language Pathology·Deanna BrittonKathryn M Yorkston
Jul 6, 2019·Practical Neurology·Martin R TurnerKevin Talbot
Jan 28, 2018·Thorax·Mika L NonoyamaLouise Rose
Dec 8, 2020·Genetics in Medicine : Official Journal of the American College of Medical Genetics·John S RichardsonLisa A Prosser
Jan 16, 2021·Pulmonology·J R BachM R Gonçalves
Mar 3, 2021·American Journal of Speech-language Pathology·Deanna BrittonJoshua O Benditt
May 24, 2021·Orphanet Journal of Rare Diseases·Shelagh M SzaboKatherine L Gooch
Jun 29, 2021·Annals of the American Thoracic Society·Mohammed M AlBalawiJoanna E MacLean

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