Hyperbare Zuurstoftherapie: Rapid Assessment - KCE
Hyperbare Zuurstoftherapie: Rapid Assessment - KCE
Hyperbare Zuurstoftherapie: Rapid Assessment - KCE
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82 Hyperbaric Oxygenation Therapy <strong>KCE</strong> Reports 74<br />
The majority of units providing services to the NHS are registered with the British<br />
Hyperbaric Association which is not regulatory, but aims to provide standards for<br />
benchmarking purposes and to facilitate research. j There are 18 centres member of the<br />
British Hyperbaric Association (Table 32).<br />
Table 32. Hyperbaric chambers in the UK<br />
Location Chamber category<br />
Aberdeen 1<br />
Gosport / Cosham 1<br />
Great Yarmouth 1<br />
Guernsey 1<br />
Hull 1<br />
Isle of Cumbrae 3<br />
Isle of Man 2<br />
Jersey 3<br />
London (Whipp's Cross) 1<br />
London (Highgate) 1<br />
Manchester 4<br />
Oban 2<br />
Orkney 2<br />
Peterborough 4<br />
Plymouth (DDRC) 1<br />
Poole 1<br />
TWI Technology Centre unknown<br />
Wirral 1<br />
Source: http://www.hyperbaric.org.uk/memberChambers.htm<br />
6.3.2 Covered indications<br />
Unlike those countries in which the range of health care benefits covered under social<br />
or private health insurance plans is defined explicitly, the NHS does not specify an<br />
explicit list of services to be provided. 136 District health authorities are free to contract<br />
service agreements with hospitals and other providers, specifying what services are to<br />
be provided and the terms on which they are to be supplied. For HBOT, district health<br />
authorities tend to use the UHMS guidelines, 8 but more and more of them are only<br />
paying for HBOT when there is RCT evidence to back its use. Some health authorities<br />
only fund the treatment of decompression illness.<br />
6.3.3 Fees for HBOT<br />
Fees are determined under the service agreements contracted between the different<br />
district health authorities and providers. As no national fixed fees are set, these may<br />
vary widely from district to district. Based on personal communication with Plymouth<br />
Hyperbaric Medical Centre, the cost range per hyperbaric session is as follows at<br />
DDRC (Diving Diseases Research Centre UK):<br />
• Standard session of 90 minutes: £96 - £240 (for non-emergency cases)<br />
• Emergency < 5hrs: £5 736.42 / 2 hrs + £1 032.55 /h<br />
• Emergency 6 – 17 hrs: £9 695.53 + £860.47 /h<br />
• Emergency >18 hrs: £19 274.35 + £114.72 /h<br />
• USNTT6: at the same rate of emergency treatments<br />
Emergency cases are for CO intoxication and diving accidents, necrotising fasciitis or<br />
gas gangrene. It is, however, difficult to compare the incidence and prevalence of<br />
indications between countries because of possible differences in definitions. CO<br />
intoxication, for example, appears to occur less frequently in the UK: only 36 fatalities<br />
and 128 casualties were recorded in 2006 for the whole of the UK, 137 compared to<br />
j Source:<br />
www.dh.gov.uk/en/PolicyAndGuidance/HealthAndSocialCareTopics/SpecialisedServicesDefinition/DH_400<br />
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