Which of the following factors must be considered when estimating a patient's cost of home mechanical ventilation? 1. Type of ventilator selected 2. Accessory medical supplies 3. Need for professional caregivers 4. Adequacy of third-party coverage

a. 1 and 3 only
b. 2 and 4 only
c. 1 and 4 only
d. 1, 2, 3, and 4

ANS: D
For homecare patients, ventilator equipment can be bought at a reasonable price; however, in many cases, families may choose to rent the ventilator because regular service, maintenance, and 24-hour emergency services are available as part of the rental contract. Unfortunately, the costs of accessory medical supplies, including items such as suction catheters, skin lotions, and absor-bent underpads, may be difficult to estimate and can significantly increase the total cost of care.
The major factor affecting the cost of home care is the need for professional or skilled care-givers. This cost depends on the availability of family members and how much they are willing and able to do. Cost also depends on patient independence and self-care abilities and the number of hours and level of care required from others.
It is important to recognize that inadequate third-party coverage for supplies and equipment, which is almost always passed on to the patient and family, must be factored into the costs of providing LTMV in the home.