TY - JOUR T1 - Variability in Home Mechanical Ventilation Prescription JO - Archivos de Bronconeumología T2 - AU - Escarrabill,Joan AU - Tebé,Cristian AU - Espallargues,Mireia AU - Torrente,Elena AU - Tresserras,Ricard AU - Argimón,Josep Ma. SN - 15792129 M3 - 10.1016/j.arbr.2015.08.003 DO - 10.1016/j.arbr.2015.08.003 UR - https://archbronconeumol.org/en-variability-in-home-mechanical-ventilation-articulo-S1579212915002888 AB - IntroductionFew studies have analyzed the prevalence and accessibility of home mechanical ventilation (HMV). The aim of this study was to characterize the prevalence of HMV and variability in prescriptions from administrative data. MethodsPrescribing rates of HMV in the 37 healthcare sectors of the Catalan Health Service were compared from billing data from 2008 to 2011. Crude accumulated activity rates (per 100000 population) were calculated using systematic component of variation (SCV) and empirical Bayes (EB) methods. Standardized activity ratios (SAR) were described using a map of healthcare sectors. ResultsA crude rate of 23 HMV prescriptions per 100000 population was observed. Rates increase with age and have increased by 39%. Statistics measuring variation not due to chance show a high variation in women (SCV=0.20 and EB=0.30) and in men (SCV=0.21 and EB=0.40), and were constant over time. In a multilevel Poisson model, hospitals with a respiratory medicine unit were associated with a greater number of cases (beta=0.68, P<.0001). ConclusionsHigh variability in prescribing HMV can be explained, in part, by the attitude of professionals toward treatment and accessibility to specialist centers with a respiratory medicine unit. Analysis of administrative data and variability mapping help identify unexplained variations and, in the absence of systematic records, are a feasible way of tracking treatment. ER -