AIMS: To compare the privately borne and NHS costs of hospital at home (HAH) and conventional inpatient care for children with selected acute conditions. METHODS: Prospective economic evaluation using cost minimisation analysis within a randomised controlled trial, in paediatric wards of a district general hospital, and private homes in the local catchment area in Wirral, Merseyside. Subjects were children who fulfilled the criteria for admission to HAH, suffering from breathing difficulties (n = 202), diarrhoea and vomiting (n = 125), or fever (n = 72). RESULTS: Direct costs borne by families are reduced by 41% for HAH patients ( pound 23.31 v pound 13.76, p = 0.001). There is no evidence that HAH transfers the burden of care to parents, and there is no difference in absence rates from paid employment. Patients and their careers expressed a strong preference for HAH. Comparison of NHS costs is equivocal, depending on how HAH is implemented alongside the conventional hospital service. CONCLUSION: Paediatric HAH schemes are unlikely to reduce NHS costs and do not increase privately borne costs. They will, however, significantly increase patient and career satisfaction with care provision for sick children with appropriate conditions.
RCT Entities:
AIMS: To compare the privately borne and NHS costs of hospital at home (HAH) and conventional inpatient care for children with selected acute conditions. METHODS: Prospective economic evaluation using cost minimisation analysis within a randomised controlled trial, in paediatric wards of a district general hospital, and private homes in the local catchment area in Wirral, Merseyside. Subjects were children who fulfilled the criteria for admission to HAH, suffering from breathing difficulties (n = 202), diarrhoea and vomiting (n = 125), or fever (n = 72). RESULTS: Direct costs borne by families are reduced by 41% for HAH patients ( pound 23.31 v pound 13.76, p = 0.001). There is no evidence that HAH transfers the burden of care to parents, and there is no difference in absence rates from paid employment. Patients and their careers expressed a strong preference for HAH. Comparison of NHS costs is equivocal, depending on how HAH is implemented alongside the conventional hospital service. CONCLUSION: Paediatric HAH schemes are unlikely to reduce NHS costs and do not increase privately borne costs. They will, however, significantly increase patient and career satisfaction with care provision for sick children with appropriate conditions.
Authors: Catherine Deri Armstrong; William E Hogg; Jacques Lemelin; Simone Dahrouge; Carmel Martin; Gary S Viner; Raphael Saginur Journal: Can Fam Physician Date: 2008-01 Impact factor: 3.275
Authors: Jacques Lemelin; William E Hogg; Simone Dahrouge; Catherine Deri Armstrong; Carmel M Martin; Wei Zhang; Jo-Anne Dusseault; Joy Parsons-Nicota; Raphael Saginur; Gary Viner Journal: BMC Health Serv Res Date: 2007-08-17 Impact factor: 2.655
Authors: Belinda von Niederhäusern; Ramon Saccilotto; Sabine Schädelin; Victoria Ziesenitz; Pascal Benkert; Marie-Luise Decker; Anya Hammann; Julia Bielicki; Marc Pfister; Christiane Pauli-Magnus Journal: BMC Med Res Methodol Date: 2017-12-08 Impact factor: 4.615