Dispensing home nebulizers for acute wheezing from the hospital is cost-effective

The objective was to investigate the use characteristics of home nebulizers and to measure the benefit gained from dispensing home nebulizers (compare d with their cost) to patients from the hospital. During the study period! August 28, 1996 to May 17, 1997, a sample of 232 of the 291 entries from a log of home nebulizers dispensed by the hospital respiratory care departmen t were surveyed over the telephone. Of the 232 study subjects under the age of 21, a telephone interview of a guardian or supervising adult was comple ted in 106 subjects (46%) a mean of 43 weeks after the home nebulizer was p rescribed (47% of the cohort received their home nebulizers from the inpati ent service and another 47% were discharged with home nebulizers from the e mergency department (ED)). An average of 3.6 estimated additional ED visits and 5.4 office/clinic visits for each patient were prevented by the home n ebulizer. The benefit (savings from reduced ED and office visits alone) to cost ratio estimates range from $855:$90 to $1710:$90 or more. The overwhel ming majority of the patients felt that the home nebulizer was a good idea, it was easy to use, they bad no problems with the nebulizer and they recei ved adequate training for home nebulizer use. Home nebulizers are a cost-ef fective means of providing home nebulized albuterol for selected outpatient s. Hospital inpatient units and EDs which have the ability to dispense a ho me nebulizer, have an additional therapeutic option available for selected patients who may benefit from it. Medical insurance companies should fully support (ie, pay for) home nebulizers because it is cost effective. If ther e is any concern about the reliability of the patient to follow up with the ir primary physician, the patient's primary physician should be contacted t o discuss the feasibility of discharging the patient with a home nebulizer. (Am J Emerg Med 2000;18:164-167. Copyright (C) 2000 by W.B. Saunders Compan y).