Objective: We compared our inpatient to outpatient setups to determine which was more cost- efficient and clinically effective. Our domiciliary NIV machines have modems which allow us to monitor patients’ compliance via Encore Anywhere.
Methods / Measures: We examined the records of COPD patients commenced on domiciliary NIV (24 inpatient, 15 outpatient) and obtained arterial blood gas results and rates of compliance, amount of air leak and frequency of exacerbations resulting in hospital admissions.
Results: Mean pCO2 prior to commencing NIV was higher in the inpatient cohort (9.54 vs 8.47), and there was a greater drop in pCO2 (36.5% vs 33.3%) during follow up. However, the average pCO2 after commencement of NIV was lower in the outpatient group (5.65 vs 6.06). Compliance (71.2% vs 67.7%), frequency of air leak (4.1% vs 4%,) and hospital admissions for exacerbations (63.9% vs 61.2%) were similar in both groups.
Conclusions: Patients set up as outpatients had similar clinical outcomes compared to those set up as inpatients. An outpatient set up saves at least £759 per patient compared to inpatient setup and would be a cost-effective way of managing the increasing number of hypercapnic COPD patients.