A model of quality assessment in patients on long-term oxygen therapy

Abstract

Background: The difficulty of implementing guidelines for long-term oxygen therapy (LTOT) has been recognized. We performed this analysis to evaluate the impact of a national quality assurance register on the quality of LTOT and to suggest indicators with levels for excellent quality LTOT.

Methods: Based on national register data on Swedish LTOT patients in 1987-2005, we measured nine quality indicators and the achievement levels of the participating counties in fulfilling these treatment criteria.

Results: There were improvements in the following eight quality indicators: access to LTOT, PaO(2) < or = 7.3 kPa without oxygen, no current smoking, low number of thoracic deformity patients without concomitant home mechanical ventilation, >16 h of oxygen/day, mobile oxygen equipment, reassessment of hypoxemia when LTOT was not started in a stable state of chronic obstructive pulmonary disease (COPD) and avoidance of continuous oral glucocorticosteroids in COPD. There was decline in the quality indicator PaO(2) > 8 kPa on oxygen. After improvements, three criteria were fulfilled by > or = 80% of the counties in 2004-2005.

Conclusions: We found improvements in eight of nine quality indicators. We suggest these indicators with levels for excellent quality for use in quality assurance of LTOT based on our results.