Article Text


Epidemiology and policy
P1-373 Using epidemiological data to inform service planning: a lesson from the Scottish home oxygen service
  1. R Wood,
  2. I Grant,
  3. M Bain
  1. NHS National Services Scotland, Edinburgh, UK


Introduction Increasing demand for home oxygen in Scotland has resulted in a shortfall in the budget for this service. In 2009, discussions began to identify financial solutions. There was a lack of understanding about what was driving increasing demand and an assumption that this reflected inappropriate over-provision. A national home oxygen needs assessment was undertaken. This considered the epidemiology of underlying conditions to examine this assumption and contribute to planning.

Methods Analysis of routinely available data to examine the epidemiology of four conditions underlying home oxygen use: chronic neonatal lung disease, cystic fibrosis, chronic interstitial lung disease, and chronic obstructive pulmonary disease. Trends in risk factors, disease incidence, prevalence and mortality, and hospital admissions were examined.

Results The prevalence of all the conditions studied has increased in Scotland over recent years due to increased incidence, increased survival, more active case finding, and/or demographic changes. Trends towards considerably shorter hospital stays and hence more community based care were noted.

Conclusions The need for home oxygen is likely to continue to increase over coming years. It will encompass all age groups and a complex range of conditions. Initial planning assumptions anticipating reducing demand for home oxygen were unsound and adjusted accordingly. Routine data, particularly in linked format, is fit for purpose in examining the epidemiology of specific conditions and contributing to planning decisions. Public health needs to be proactive in providing relevant needs assessment information to ensure that planning within financial constraints is appropriately informed by population needs.

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