Medical Electronic Prescription for Home Respiratory Care Services (PEM-CRD) at a Portuguese University Tertiary Care Centre (2014–2018): A Case Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Statistical Analysis
2.3. Ethical Approval
3. Results
3.1. Characterization of HRC Users
3.2. Evolution of HRC Users (2014–2018)
3.3. Evolution of HRC Prescriptions (2014–2018)
3.4. HRC Prescriptions and Users (2014–2018)
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Year | 2014 | 2015 | 2016 | 2017 | 2018 | % Variation 2018/2014 | |||||
---|---|---|---|---|---|---|---|---|---|---|---|
Number of patients underHRC treatment 1 | 3796 | 3988 | 4125 | 4093 | 4344 | 14.4% | |||||
Therapies | |||||||||||
Nr. of therapies | 4297 | 4514 | 4715 | 4684 | 4952 | 15.2% | |||||
Type and subtype of therapies 2 | |||||||||||
Aerosol therapy | 450 | (10.5%) | 289 | (6.4%) | 245 | (5.2%) | 279 | (6.0%) | 194 | (3.9%) | −56.9% |
Ventilation therapy | 2490 | (57.9%) | 2777 | (61.5%) | 2899 | (61.5%) | 2960 | (63.2%) | 3260 | (65.8%) | 30.9% |
Oxygen therapy | 1263 | (29.4%) | 1334 | (29.6%) | 1445 | (30.6%) | 1316 | (28.1%) | 1383 | (27.9%) | 9.5% |
Ventilation adjuvant | 45 | (1.0%) | 77 | (1.7%) | 80 | (1.7%) | 88 | (1.9%) | 66 | (1.3%) | 46.7% |
Ambulation | 56 | (1.3%) | 183 | (4.1%) | 253 | (5.4%) | 260 | (5.6%) | 319 | (6.4%) | 469.7% |
Short-term oxygen therapy | 184 | (4.3%) | 112 | (2.5%) | 148 | (3.1%) | 116 | (2.5%) | 110 | (2.2%) | −40.2% |
Long-term oxygen therapy | 925 | (21.5%) | 929 | (20.6%) | 920 | (19.5%) | 802 | (17.1%) | 844 | (17.0%) | −8.8% |
Palliative | 53 | (1.2%) | 33 | (0.7%) | 44 | (0.9%) | 50 | (1.1%) | 44 | (0.9%) | −17% |
Other treatments | 94 | (2.2%) | 114 | (2.5%) | 126 | (2.7%) | 129 | (2.8%) | 115 | (2.3%) | 22.3% |
Nr. of patients with 1 or more therapies | |||||||||||
1 type of therapy | 3508 | (92.4%) | 3682 | (92.3%) | 3813 | (92.4%) | 3771 | (92.1%) | 4026 | (92.7%) | 14.8% |
2 types of therapy | 257 | (6.8%) | 283 | (7.1%) | 284 | (6.9%) | 293 | (7.2%) | 288 | (6.6%) | 12.1% |
3 types of therapy | 28 | (0.7%) | 22 | (0.6%) | 26 | (0.6%) | 28 | (0.7%) | 27 | (0.6%) | −3.6% |
4 types of therapy | 3 | (0.1%) | 1 | (0.0%) | 2 | (0.0%) | 1 | (0.0%) | 3 | (0.1%) | 0.0% |
Year | 2014 | 2015 | 2016 | 2017 | 2018 | % Variation 2018/2014 |
---|---|---|---|---|---|---|
Total of prescriptions | 43,417 | 51,358 | 58,893 | 15,453 | 9419 | −78.3% |
Treatments: | ||||||
Aerosol therapy | 4100 (9.4%) | 2245 (4.4%) | 3266 (5.5%) | 1022 (6.6%) | 468 (5.3%) | −88.6% |
Other treatments | 895 (2.1%) | 1418 (2.8%) | 1418 (2.4%) | 373 (2.4%) | 226 (2.4%) | −74.7% |
Oxygen therapy | 10,067 (23.2%) | 12,886 (25.1%) | 14,508 (24.6%) | 3539 (22.9%) | 2274 (24.1%) | −77.4% |
Adjuvant vent. therapy | 393 (0.9%) | 714 (1.4%) | 977 (1.7%) | 252 (1.6%) | 115 (1.2%) | −70.7% |
Ambulation | 332 (0.8%) | 1596 (3.1%) | 2381 (4.0%) | 651 (4.2%) | 503 (5.3%) | 51.5% |
Short-term oxygen therapy | 853 (2.0%) | 557 (1.1%) | 781 (1.3%) | 236 (1.5%) | 131 (1.4%) | −84.6% |
Long-term oxygen therapy | 8284 (19.1%) | 9834 (19.1%) | 10,060 (17.1%) | 2269 (14.7%) | 1404 (14.9%) | −83.1% |
Palliative | 205 (0.5%) | 185 (0.4%) | 309 (0.5%) | 131 (0.8%) | 121 (1.3%) | −41.0% |
Ventilation therapy | 28,355 (65.3%) | 34,809 (67.8%) | 39,701 (67.4%) | 10,519 (68.1%) | 6451 (68%) | −77.2% |
Prescription type: | ||||||
Initial | 28,172 (64.9%) | 23,912 (46.6%) | 6516 (11.1%) | 2045 (13.2%) | 1585 (16.8%) | −94.4% |
Renewal | 14,747 (34.0%) | 26,316 (51.2%) | 51,195 (86.9%) | 12,983 (84.0%) | 7302 (77.5%) | −50.5% |
Modification | 498 (1.1%) | 1130 (2.2%) | 1182 (2.0%) | 425 (2.8%) | 532 (5.6%) | 6.8% |
Clinical context: | ||||||
Hospital care | 26,709 (61.5%) | 25,701 (50.0%) | 32,375 (55.0%) | 8277 (53.6%) | 5426 (57.6%) | −79.7% |
Primary care | 16,708 (38.5%) | 25,657 (50.0%) | 26,518 (45.0%) | 7176 (46.4%) | 3993 (42.4%) | −76.1% |
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Alves, R.; Caneiras, C.; Santos, A.I.; Barbosa, P.; Cardoso, J.; Caseiro, P.; Vitorino, M.J.; Pereira, J.; Escoval, A. Medical Electronic Prescription for Home Respiratory Care Services (PEM-CRD) at a Portuguese University Tertiary Care Centre (2014–2018): A Case Study. Sustainability 2020, 12, 9859. https://doi.org/10.3390/su12239859
Alves R, Caneiras C, Santos AI, Barbosa P, Cardoso J, Caseiro P, Vitorino MJ, Pereira J, Escoval A. Medical Electronic Prescription for Home Respiratory Care Services (PEM-CRD) at a Portuguese University Tertiary Care Centre (2014–2018): A Case Study. Sustainability. 2020; 12(23):9859. https://doi.org/10.3390/su12239859
Chicago/Turabian StyleAlves, Ricardo, Cátia Caneiras, Ana Isabel Santos, Patricia Barbosa, João Cardoso, Paulo Caseiro, Maria João Vitorino, João Pereira, and Ana Escoval. 2020. "Medical Electronic Prescription for Home Respiratory Care Services (PEM-CRD) at a Portuguese University Tertiary Care Centre (2014–2018): A Case Study" Sustainability 12, no. 23: 9859. https://doi.org/10.3390/su12239859