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Canadian Respiratory Journal - Volume 22 2015, Issue 6, Pages 324-330

Original Article Centre de recherche, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada



Copyright © 2015 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND: In Canada, although medical insurance is generally universal, significant differences exist in the provision of home oxygen therapy across the country.

OBJECTIVE: To systematically compare the terms of reference for home oxygen across Canada, with a focus on the clinical inclusion criteria to the programs.

METHODS: The authors searched the terms of reference of the 10 Canadian provinces and three territories, focusing on general eligibility criteria for home oxygen including blood gas criteria, and eligibility criteria for ambulatory and nocturnal oxygen, and compared the eligibility criteria to the widely accepted criteria of the Nocturnal Oxygen Therapy Trial NOTT trial, the clinical recommendations of the Canadian Thoracic Society and the results of Cochrane reviews.

RESULTS: The terms of reference for nine provinces were retrieved. All jurisdictions have similar criteria for long-term oxygen therapy, with slight differences in the thresholds of prescription and the clinical criteria defining ‘pulmonary hypertension’ or ‘cor pulmonale’. The use of oxyhemoglobin saturation as a criterion for funding is inconsistent. All nine provinces fund nocturnal oxygen, all with different clinical criteria. Funding for portable oxygen widely varies across provinces, whether the ambulatory equipment is offered to patients on long-term oxygen therapy or to those who have isolated exercise-induced desaturation. The terms of reimbursement are very heterogeneous.

CONCLUSIONS: Heterogeneity exists in the criteria for eligibility to home oxygen programs and funding across Canada. Terms of prescription and reimbursement of oxygen are not necessarily supported by available evidence from the current literature in several Canadian jurisdictions.





Autor: Yves Lacasse, Sarah Bernard, and François Maltais

Fuente: https://www.hindawi.com/



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