Home health care for children assisted by mechanical ventilation: the physician's perspective.

To obtain the physician's perspective concerning their care of children at home who required prolonged life-supportive medical technology, we conducted a mailed survey of 126 physicians caring for 25 children assisted by ventilators who had been discharged from 11 Illinois hospitals to their homes. The 51 (41%) physicians who responded included those practicing in many specialties from a variety of hospital settings throughout Illinois. The majority of respondents had less than 4 years' experience with ventilator-assisted children and were in their earlier years of practice. Most physicians surveyed had participated in discharge planning and maintained an active role with their patients at home after discharge. The majority believed that changes in ventilatory settings could be accomplished in the home and found hospitalization unnecessary for adjustments of the home care prescription. The physicians thought that the roles and responsibilities should be defined for both the tertiary and community-based physician before hospital discharge, and that development and support of resources at the community level were essential for the success of home care.