From 1958 to 1967, 148 patients with severe chronic respiratory insufficiency have been managed in a "Home Care Program," which has primarily involved concentrated care in the home by nurses and other paramedical personnel, as well as by hospital residents. Therapeutic measures were directed at reduction in work of breathing, an increase in alveolar ventilation and physical activity, and when necessary, provision of mechanical aids. Of the patients, 55% required rehospitalization, but for only 5.7% of the total days on home care. Of the 148 patients, 47% died after they had been on the program for an average of 361 days. The cost of the program was slight, particularly when compared to that of a hospital bed, and the cost of physician care constituted a very small portion of the total cost.