ABSTRACT

Background: Supplemental oxygen is a therapeutic tool almost universally prescribed to patients admitted to the National Institute of Respiratory Diseases Ismael Cosío Villegas (INER). Objectives: The objectives of this study were: 1) measured by an active certification process, if the dose of supplemental oxygen via nasal cannula in hospitalized patients INER, is appropriate to maintain an oxygen saturation (SpO₂) stable three breakpoints (≥ 88, ≥ 90 and ≥ 93%), 2) pursuant to the foregoing, we quantify the over-or under-dosing of oxygen considering the three breakpoints identified, 3) in case of over-dosing of oxygen, we calculate the cost derived from the waste of oxygen, and 4) as an indicator of quality of care, determine the proportion of patients receiving less oxygen than required for hypoxemia. Results: The main results of this study are: 1) in hospitalized patients, there is a waste of oxygen according to the cutoffs considered appropriate oxygenation, which decreases with increasing the cutoff criterion of proper oxygenation of SpO₂ ≥ 88, ≥ 90, and ≥ 93%, respectively, 2) when considering the proper qualification criteria oxygen ± 0.5L/min and ± 1L/min, there is still a waste of oxygen in thousands liters per hospitalization per patient, since the proportion of titration right for each cut point is very low, 3) the costs of waste of oxygen in hospitalized patients in the INER is high, from $ 500.00 to $ 600.00 pesos per hospital stay per patient, which has a major impact given the number of patients requiring supplemental oxygen and are admitted to the INER, and 4) the proportion of patients receiving less oxygen than is needed is low, but increases in as the cutoff increases, SpO₂ ≥ 88, ≥ 90, and ≥ 93%, with 0.9, 7.3 and 22% respectively. Conclusions: There is an overdose of supplemental oxygen in hospitalized patients. Efforts should be made to ensure an adequate degree of oxygen in hospitalized patients. In the INER, the proportion of patients with hypoxemia who received less oxygen than required is very low, which may be due to the INER is a national reference institute for respiratory diseases, in contrast to what might be observed in general hospitals.

KEYWORDS

Titration of oxygen, hospitalization, direct costs.

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