To analyse home mechanical ventilation (HMV) from a community perspective.
To analyse healthcare delivery alternatives.
To consider different sources of variability in clinical practice.
To emphasise the role of patients in the decision-making process.
Summary The number of patients using HMV is increasing in all Western countries. There has been a significant increase in the number of obese patients and – despite the restrictive recommendations of the guidelines – of patients with chronic obstructive pulmonary disease (COPD). In most countries, there are no systematic registers of patients, outcomes are not followed regularly and support at home is very variable.
It is very important to think about how to organise the care of patients on HMV: it must seek a balance between the role of reference centres and accesibility to local hospitals. Networking should be a reasonable alternative.
- ©ERS 2009