Health care utilisation of prematurely born preschool children related to home oxygen status in the first two years

Objective: To determine, in prematurely born children who had BPD, if respiratory morbidity, healthcare utilisation and cost of care during the preschool years were influenced by use of supplementary oxygen at home after NICU discharge. Design: Observational study. Setting: Four tertiary neonatal intensive care units. Patients: 190 children, median gestational age 27 (range 22-31) weeks, 70 of whom when discharged home received supplementary oxygen. Interventions: Review of hospital and general practitioner records together with a parent completed respiratory questionnaire. Main outcome measures: Health care utilisation, cost of care, cough, wheeze and use of an inhaler, Results: Seventy children had supplementary oxygen at home (home oxygen group), but only one had a continuous requirement for home oxygen beyond two years of age. There were no significant differences in the gestational age or birth weight of the home oxygen children compared to the rest of the cohort. Between two and four years of age inclusive, the home oxygen children, however, had more outpatient attendances (p=0.0021) and specialist attendances (p=0.0023) and for respiratory problems required more prescriptions (p<0.0001). Their total cost of care was higher (p<0.0001). In addition, more of the home oxygen group wheezed more than once a week (p=0.048) and were more likely to use an inhaler (p<0.0001). Conclusion: Children who had BPD and had supplementary oxygen at home following NICU discharge have increased respiratory morbidity and health care utilisation in the preschool years.