Home visits are a bit like Marmite; you either love them or hate them. Patients who are on oxygen require monitoring to see if their oxygen requirement alters over time and this can be done either via home visits or by going to see your GP or consultant at the hospital. Patients have differing opinions over which they feel is more suitable; some feel uncomfortable at the thought of medical personnel invading their personal space at home and prefer the professional and clinical setting of a hospital and some feel that there is little medical benefit to them being seen at home. Whereas others prefer to have to not travel back and forth in their condition and feel more at ease talking to someone in the comfort of their own home. They also feel more able to discuss the smaller things and ask questions during their own home visits rather than at an apparent rushed GP or hospital appointment.
home exchanges
Studies have been carried out to get feedback from patients as to problems they encounter and also to see if there are medical benefits of one method over another.
One such study asked patients about their experiences of using oxygen at home. There was feedback regarding trailing tubing, allergic reactions/irritations to tubing, preferred use of nasal cannulae over masks, continuity problems with supply, portable equipment not being of a portable size, preference of concentrators over cylinders, reduction in infections and less reliance on other medications. There were many that said that they struggled with getting to grips with oxygen use for varying reasons and life was difficult for them until their home visit resolved these for them. The home visit provided them with an opportunity to ask questions and show their home visitor what their issues were. In most cases their questions could be answered, tips/advice given, shown practically how to use their equipment more effectively, educate them on oxygen use and feedback to the hospital or oxygen supply company to resolve issues and monitor the situation to ensure that things were done. Many did not realise that they had options and could contact their supplier or use a private supplier if they wished in order to obtain better equipment that would suit their medical condition or way of life better. There are many studies that show that home visits aid in reducing mortality and readmission into hospital.
A study has been carried out by an NHS trust to ascertain whether home visits were useful and it was realised that home visits allowed for problems to be identified and interventions made to improve the way oxygen is used at home generally, and not just on a case-by-case basis. The most common interventions related to the need of more education, smoking cessation, concentrator maintenance, use of a humidifier and adjustments to tubing. It was found that they were especially important for those who lacked progress of their condition, which in many cases was due to a lack of education of how to use it properly or difficulties in using it, which resulted in reduced use. These issues can be quickly dealt with by home visits and monitoring of patient progress is also easier. It is also a mode for early detection of potential health problems or prevention against flare-ups or emergency situations, which may have been caused by a lack of understanding of their condition or their equipment.
It appears from the studies that home visits are very beneficial to the hospital service and to the patient. It is also more cost-effective to provide this service than to run it from the hospital and not incur the costs of more hospital admissions. Patient progress is monitored, patient’s concerns and problems are discovered and resolved which results in a better prognosis for the patient and a reduction of cost for the hospital. Some patients will still need to see their GP or consultant depending on their condition and regular contact should still be maintained but if these can be reduced to a minimum because of home visits then it is extremely beneficial for the patient’s general well-being.
References: http://www.gov.scot and http://www.ncbi.nlm.nih.gov