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Park, Yoo, Choi, Kim, Yoon, Kang, Lee, Choi, Lee, Lee, Lim, Kim, Shin, Kim, Jung, and Park: Long-term Oxygen Therapy for Chronic Respiratory Insufficiency: the Situation in Korea after the Health Insurance Coverage: a Multi-center Korean Survey -Study for the Development and Dissemination of the COPD Guidelines, Clinical Research Center for Chronic Obstructive Airway Disease-
Research Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2009; 67(2): 88-94.

Published online: 31 August 2009

DOI: https://doi.org/10.4046/trd.2009.67.2.88

Long-term Oxygen Therapy for Chronic Respiratory Insufficiency: the Situation in Korea after the Health Insurance Coverage: a Multi-center Korean Survey -Study for the Development and Dissemination of the COPD Guidelines, Clinical Research Center for Chronic Obstructive Airway Disease-

Myung Jae Park, M.D.1, Jee-Hong Yoo, M.D.1, Cheon Woong Choi, M.D.1, Young Kyoon Kim, M.D.2, Hyoung-Kyu Yoon, M.D.2, Kyung Ho Kang, M.D.3, Sung Yong Lee, M.D.3, Hye Sook Choi, M.D.4, Kwan Ho Lee, M.D.5, Jin Hwa Lee, M.D.6, Sung-Chul Lim, M.D.7, Yu-Il Kim, M.D.7, Dong Ho Shin, M.D.8, Tae-Hyung Kim, M.D.8, Ki-Suck Jung, M.D.9, Yong Bum Park, M.D.9

1Department of Internal Medicine, Kyung Hee University, Seoul, Korea.

2Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.

3Department of Internal Medicine, Korea University, Seoul, Korea.

4Department of Internal Medicine, Dongguk University, Gyeongju, Korea.

5Department of Internal Medicine, Yeungnam University, Daegu, Korea.

6Department of Internal Medicine, Ewha Womans University, Seoul, Korea.

7Department of Internal Medicine, Chonnam University, Gwangju, Korea.

8Department of Internal Medicine, Hanyang University, Seoul, Korea.

9Department of Internal Medicine, Hallym University, Chuncheon, Korea.

Address for correspondence: Jee-Hong You, M.D. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, East-West Neo Medical Center, Kyung Hee University College of Medicine, 149, Sangil-dong, Kangdong-gu, Seoul 134-727, Korea. Phone: 82-2-440-6117, Fax: 82-2-440-6295, honglung@chollian.net

Received 14 June 2009       Accepted 8 July 2009

Copyright©2009. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Background

From November 2006, The national health insurance system in the Republic of Korea began to cover prescribed long-term oxygen therapy (LTOT) in patients with chronic respiratory insufficiency. This study examined the current status of LTOT after national health insurance coverage.

Methods

Between November 1, 2006 and June 30, 2008, the medical records of patients who were prescribed LTOT by chest physicians were reviewed. The data was collected from 13 university hospitals.

Results

197 patients (131 male and 66 female) were prescribed LTOT. The mean age was 64.3±13.0 years. The most common underlying disease was chronic obstructive pulmonary disease (n=103, 52.3%). Chest physicians prescribed LTOT using arterial blood gas analysis or a pulse oxymeter (74.6%), symptoms (14%), or a pulmonary function test (11.2%). The mean oxygen flow rate was 1.56±0.68 L/min at rest, 2.08±0.91 L/min during exercise or 1.51±0.75 L/min during sleep. Most patients (98.3%) used oxygen concentrators. Only 19% of patients used ambulatory oxygen supplies. The oxygen saturation before and after LTOT was 83.18±10.48% and 91.64±7.1%, respectively. After LTOT, dyspnea improved in 81.2% of patients. The mean duration of LTOT was 16.85±6.71 hours/day. The rental cost for the oxygen concentrator and related electricity charges were 48,414±15,618 won/month and 40,352±36,815 won/month, respectively. Approximately 75% of patients had a regular visit by the company. 5.8% of patients had personal pulse oxymetry. 54.9% of patients had their oxygen saturation checked on each visit hospital. 8% of patients were current smokers. The most common complaint with LTOT was the limitation of daily activity (53%). The most common complaint with oxygen concentrators was noise (41%).

Conclusion

The patients showed good compliance with LTOT. However, only a few patients used an ambulatory oxygen device or had their oxygen saturation measured.

Keywords: Long-term home oxygen therapy, Reimbursement, Chronic respiratory insufficiency, COPD

Figures and Tables

Figure 1
Distribution of age in the study population with long-term oxygen therapy.
trd-67-88-g001
Figure 2
Changes of SaO2 before and after the use of LTOT Using the paired t-test, p<0.001. LTOT: long-term oxygen therapy.
trd-67-88-g002
Figure 3
Changes in the patients' quality of life after long-term oxygen therapy.
trd-67-88-g003
Figure 4
Total rental fee for oxygen concentrator (reimbursement rates are 96,000 won/month).
trd-67-88-g004
Figure 5
Reported complaints with regard to long-term oxygen therapy.
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Table 1
Patients characteristics
trd-67-88-i001

FEV1: forced expiratory volume in one second; FVC: forced vital capacity.

Table 2
Underlying disease
trd-67-88-i002

COPD: chronic obstructive lung disease; TB: tuberculosis; ILD: interstitial lung disease.

*Sleep apnea, tuberous sclerosis, primary pulmonary hypertension, muscular dystrophy.

Table 3
Bases for prescription of LTOT
trd-67-88-i003

LTOT: long-term oxygen therapy.

Table 4
Delivery of oxygen
trd-67-88-i004
Table 5
Monitoring for LTOT
trd-67-88-i005

LTOT: long-term oxygen therapy.

*Customer service staff of oxygen generator provider.

Table 6
Cost for LTOT
trd-67-88-i006

LTOT: long-term oxygen therapy.

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