The Science Journal of the American Association for Respiratory Care

1997 OPEN FORUM Abstracts

Home Care in Europe

Patrick Leger, MD, and Susan Sorter Leger, RRT, Monday, December 8, 1997.

The contrast between a lean welfare state with rapid job growth in the United States and a costly social welfare system with persistently high unemployment in most of Europe has given rise to many debates. The question is which model is the way of the future. The fact is that Europe has many models of social welfare and some are extremely efficient. As the Prime Minister Tony Blair of Britain insists, maybe there is a < < third way>> between the two paths. Some European countries have successfully achieved universal health care coverage while maintaining an economy that is very efficient per working hour.

As was the case in the USA, the development of home respiratory care (HRC) in Europe resulted from the home care programs of the poliomyelitis centers. The first home care efforts were regional, created by pioneers in the field of HRC with financial support of the national health care systems. In most European countries, these centers have continued without interruption since this period of time. Respiratory Home Care equipment continues to be provided as part of most national health care programs.

Commercial companies in most countries provide the supply of home respiratory equipment. In some countries there is, in addition, cooperation between hospitals and regional associations for the purchase of more sophisticated equipment. Many countries report a need to improve the quality and consistency of home monitoring.

The technicians of the commercial companies and/or the regional association usually provide technical supervision. In general, technical monitoring is much more organized and consistent than home patient monitoring and supervision. Nurses and sometimes physicians, most frequently do patient monitoring, when provided, from prescribing organizations or hospitals.

Finally, the number of patients treated per 100,000 inhabitants varies markedly between countries. This cannot be explained by differences in the incidence of pulmonary disease or by reimbursement issues but may be due to the differences in prescription habits and the information available to the physicians and the consumers.

Europeans are known for their insistence on quality of life rather than growth at any cost. When considering health care for our community, is it worth considering a third way?????

AARC 50th Anniversary, December 6 - 9, 1997, New Orleans, Louisiana.

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