Until recently, the number of LTACHs in the U.S. has grown rapidly. Changes in national healthcare policy, however, have greatly affected the organization of these hospitals as well as the types of services offered. Purchasing constraints have been further compounded by challenges stemming from conditions in the U.S. economy. This report examines trends in long-term acute care device markets, and provides patient and product forecasts for respiratory therapy, wound care, renal failure, and monitoring technologies through 2017.
1. EXECUTIVE SUMMARY 1.1 Trends in LTACH Growth 1.1.1 The 25 Percent Rule 1.1.2 Short-Stay Outliers 1.1.3 Facility Expansions 1.2 Developments in the U.S. Economy 1.3 Patient Volumes and Clinical Practice 1.3.1 Respiratory Patients 1.3.2 Wound Care Patients 1.3.3 Renal Failure Patients 1.3.4 Other Patients 1.4 Capital Equipment 1.5 Aftermarket Sales 1.6 Competitive Analysis Exhibit 1-1: Long-Term Acute Care in the U.S., Facilities and Beds, 2009-2017 Exhibit 1-2: Long-Term Acute Care, U.S. Patient Forecast by Primary LTC-DRG, 2009-2017 Exhibit 1-3: Selected Capital Equipment in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 1-4: Selected Accessories and Service Revenues in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 2. OVERVIEW 2.1 Long-Term Acute Care Facilities in the U.S. 2.1.1 Goals and Purpose 2.1.2 LTACH Patients 2.1.3 Factors Affecting Long-Term Acute Care 2.2 Trends in Long-Term Acute Care 2.2.1 Facility Forecast 2.2.1.1 Urban Centers 2.2.1.2 Rural Centers 2.2.1.3 Freestanding Centers 2.2.1.4 Hospitals-within-Hospitals 2.2.2 Trends in Length of Stay and Resource Utilization Exhibit 2-1: Long-Term Acute Care Patients in the U.S. in 2011 by Type Exhibit 2-2: Long-Term Acute Care Facilities, U.S. Forecast, 2009-2017 Exhibit 2-3: Long-Term Acute Care Patients, Trends in Length-of-Stay, 2011-2017 3. RESPIRATORY THERAPY PRODUCTS 3.1 Ventilators 3.1.1 Companies and Products 3.2 Oxygen Delivery Devices 3.2.1 Companies and Products 3.3 Aerosol Delivery Devices 3.3.1 Companies and Products Exhibit 3-1: Modes of Ventilation Used in Long-Term Acute Care Exhibit 3-2: Selected Ventilator Products in 2011 Exhibit 3-3: Selected Oxygen Delivery Devices Exhibit 3-4: Selected Types of Aerosol Delivery Devices Exhibit 3-5: Distinguishing Features of Aerosol Delivery Devices Exhibit 3-6: Advantages/Disadvantages of ADDs in LTACHs Exhibit 3-7: Selected Aerosol Delivery Devices in 2011 4. WOUND CARE PRODUCTS 4.1 Management and Treatment 4.1.1 Management Strategies 4.1.2 Wound Care Products 4.1.2.1 Standard and Advanced Wound Dressings 4.1.2.1.1 Companies and Products 4.1.2.2 Negative Pressure Wound Therapy 4.1.2.2.1 Companies and Products 4.1.2.3 Skin Substitutes 4.1.2.4 Other Products Exhibit 4-1: Wounds Encountered in Long-Term Acute Care Exhibit 4-2: Wound Management and Treatment Strategies for LTACH Patients Exhibit 4-3: Standard and Advanced Wound Dressings Exhibit 4-4: Selected Wound Dressing Products in 2011 Exhibit 4-5: Selected Negative Pressure Wound Therapy Systems 5. THERAPY FOR RENAL FAILURE 5.1 Hemodialysis 5.2 Hemofiltration 5.3 Peritoneal Dialysis 5.4 Companies and Products Exhibit 5-1: Therapies for Renal Failure Exhibit 5-2: Types of Peritoneal Dialysis Exhibit 5-3: Selected Dialysis Devices 6. MONITORING TECHNOLOGIES 6.1 Cardiac Monitors 6.2 Pulse Oximeters 6.3 Blood Pressure Monitors 6.4 Companies and Products Exhibit 6-1: Monitoring Technologies Used in the LTACH Exhibit 6-2: Vital Signs Monitoring Parameters Exhibit 6-3: Types of Pulse Oximeters Exhibit 6-4: Selected Monitoring Technologies 7. LONG-TERM ACUTE CARE IN THE U.S.: PATIENTS & MARKETS 7.1 Facility Growth Through 2017 7.1.1 National Policies 7.1.1.1 The 25 Percent Rule 7.1.1.2 Policies Affecting Short-Stay Outliers 7.1.1.3 Legislative Actions 7.1.2 Economic Developments 7.1.3 Facility Forecast 7.2 Patient Forecasts 7.2.1 Respiratory Patients 7.2.1.1 Respiratory Conditions 7.2.1.1.1 Mechanical Ventilation Patients 7.2.1.1.2 Pulmonary Edema and Respiratory Failure 7.2.1.1.3 Pneumonia 7.2.1.1.4 COPD 7.2.1.1.5 Other Respiratory Conditions 7.2.1.2 Respiratory Patient Forecast 7.2.2 Wound Care Patients 7.2.2.1 Wound Types 7.2.2.1.1 Pressure Ulcers 7.2.2.1.2 Post-Operative Wounds 7.2.2.1.3 Other Wound Patients 7.2.2.2 Wound Care Patient Forecast 7.2.3 Renal Failure Patients 7.2.4 Other Patients 7.3 Market Analysis 7.3.1 Capital Equipment 7.3.1.1 Policies Limiting Facility Growth 7.3.1.2 Conditions in the U.S. Economy 7.3.1.3 Price Competition 7.3.1.4 Ventilators 7.3.1.5 NPWT Systems 7.3.1.5.1 The Impact of Equipment Rentals 7.3.1.5.2 Price Competition and Competitive Trialing 7.3.1.5.3 Shifting Treatment Patterns 7.3.1.6 NPWT Systems - Market Forecast 7.3.1.7 Dialysis Machines 7.3.1.8 Cardiac Monitors, Pulse Oximeters, and NIBP 7.3.1.8.1 Cardiac Monitors 7.3.1.8.2 Pulse Oximeters 7.3.1.8.3 Blood Pressure Monitors 7.3.2 Aftermarket Sales and Patient Consumables 7.3.2.1 Airway Management Products 7.3.2.2 Oxygen Therapy Products 7.3.2.3 Aerosol Delivery Devices 7.3.3 Wound Care Consumables 7.3.3.1 NPWT Accessories 7.3.3.2 Topical Wound Dressings 7.3.3.3 Dialysis Accessories 7.3.3.4 Patient Monitoring Accessories 7.3.4 Competitive Analysis Exhibit 7-1: Factors Influencing Facility Growth Through 2017 Exhibit 7-2: Long-Term Acute Care Facilities and Beds in the U.S., 2009-2017 Exhibit 7-3: Long-Term Acute Care Facilities by Location and Type in the U.S., 2011 & 2017 Exhibit 7-4: U.S. LTACH Patient Forecast, 2009-2017 Exhibit 7-5: Respiratory Patients in Long-Term Acute Care, U.S. Forecast, 2009-2017 Exhibit 7-6: Pressure Ulcer Patients in Long-Term Acute Care, U.S. Forecast, 2009-2017 Exhibit 7-7: Wound Patients in Long-Term Acute Care, U.S. Forecast, 2009-2017 Exhibit 7-8: Renal Failure Patients in Long-Term Acute Care, U.S. Forecast, 2009-2017 Exhibit 7-9: Other Long-Term Acute Care Patients, U.S. Forecast, 2009-2017 Exhibit 7-10: Ventilators in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-11: Negative Pressure Wound Therapy Systems in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-12: Hemodialysis Systems in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-13: Cardiac Monitors in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-14: Pulse Oximeters in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-15: Pulse Oximeters by Type, U.S. Market Forecast, 2009-2017 Exhibit 7-16: Blood Pressure Monitors in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-17: Airway Management Products and Ventilator Accessories in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-18: Oxygen Therapy Consumables in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-19: High-Flow Oxygen Therapy Consumables in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-20: Low-Flow Oxygen Therapy Consumables in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-21: Aerosol Delivery Devices in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-22: Metered Dose Inhalers in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-23: Small and Large Volume Nebulizers in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-24: Ultrasonic Nebulizers in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-25: NPWT Accessories in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-26: Standard Wound Dressings in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-27: Advanced Wound Dressings in the LTACH, U.S. Market Forecast, 2009-2017 Exhibit 7-28: LTACH Wound Dressings, U.S. Market Forecast, 2011 & 2017 Exhibit 7-29: Dialysis Accessories in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-30: Patient Monitoring Accessories in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-31: Selected Accessories and Service Revenues in Long-Term Acute Care, U.S. Market Forecast, 2009-2017 Exhibit 7-32: Competitors in Long-Term Acute Care in 2011 8. COMPANY PROFILES 8.1 CareFusion 8.2 Covidien 8.3 Fresenius Medical Care 8.4 GE Healthcare 8.5 Kinetic Concepts, Inc. (KCI) 8.6 Philips Healthcare