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Topics in Practice Management |

Long-term Oxygen Therapy

Kent L. Christopher, MD, RRT, FCCP; Phillip Porte, BA
Author and Funding Information

From the Clinical Faculty of the Division of Pulmonary/Critical Care (Dr Christopher), University of Colorado Health Sciences Center, Denver, CO; and the National Association for Medical Direction of Respiratory Care (Mr Porte), Vienna, VA.

Correspondence to: Kent L. Christopher, MD, RRT, FCCP, 9086 E Colorado Circle, Denver, CO 80231; e-mail: drkchristopher@comcast.net.


For editorial comment see page 238

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;139(2):430-434. doi:10.1378/chest.10-0242
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This article provides an overview of the status of long-term oxygen therapy (LTOT). In the United States, payment cutbacks are occurring as a result of congressionally mandated competitive bidding and capped rental programs. These Medicare programs are discussed. These legislative and regulatory changes may result in reduced patient access to appropriate oxygen-delivery systems that meet medical needs, including optimal ambulation. Prescribing LTOT is addressed in this article, as is the need for adequate patient education. The importance of appropriate monitoring and reassessment is presented. The use of an LTOT collaborative care model is discussed. Although the new intermittent flow oxygen-delivery systems have potential benefits, there is consensus that each patient should be tested on the specific device because of variability in delivery and patient response. Feasible locations for patient education and monitoring are identified.


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