PT - JOURNAL ARTICLE AU - J. Escarrabill TI - Organisation and delivery of home mechanical ventilation AID - 10.1183/18106838.0601.036 DP - 2009 Sep 01 TA - Breathe PG - 36--42 VI - 6 IP - 1 4099 - http://breathe.ersjournals.com/content/6/1/36.short 4100 - http://breathe.ersjournals.com/content/6/1/36.full SO - breathe2009 Sep 01; 6 AB - Educational aims 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.