BACKGROUND: This paper compares the cost efficacy of care at an intermediate level in a community hospital or a conventional prolonged treatment in a general hospital. MATERIAL AND METHODS: 142 patients older than 60 years and admitted to the city general hospital (due to an acute illness or exacerbation of a chronic disease) were randomised to one of the two types of care. Patients were followed for one year or until death and costs for care were monitored. RESULTS:Mean costs for treatment of the disease in question at the time of inclusion were 39,650 NOK (95% CI 30,996-48,304) in the community hospital group and 73,417 NOK (95 % CI 52,992-93,843) in the general hospital group (p < 0.01). No significant differences were found for the municipality and general hospital care costs during follow-up, except for readmissions. Mean health service costs per patient per observed day were 606 NOK (95% CI 450-761) for the community hospital group and 802 NOK (95 % CI 641-962) for the general hospital group (p = 0.03). INTERPRETATION: Care at an intermediate level in a community hospital in Trondheim was given for a lower cost compared to that given in a general hospital. The main reason for the difference was the reduction in readmission costs.
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BACKGROUND: This paper compares the cost efficacy of care at an intermediate level in a community hospital or a conventional prolonged treatment in a general hospital. MATERIAL AND METHODS: 142 patients older than 60 years and admitted to the city general hospital (due to an acute illness or exacerbation of a chronic disease) were randomised to one of the two types of care. Patients were followed for one year or until death and costs for care were monitored. RESULTS: Mean costs for treatment of the disease in question at the time of inclusion were 39,650 NOK (95% CI 30,996-48,304) in the community hospital group and 73,417 NOK (95 % CI 52,992-93,843) in the general hospital group (p < 0.01). No significant differences were found for the municipality and general hospital care costs during follow-up, except for readmissions. Mean health service costs per patient per observed day were 606 NOK (95% CI 450-761) for the community hospital group and 802 NOK (95 % CI 641-962) for the general hospital group (p = 0.03). INTERPRETATION: Care at an intermediate level in a community hospital in Trondheim was given for a lower cost compared to that given in a general hospital. The main reason for the difference was the reduction in readmission costs.
Authors: Alyson L Huntley; Melanie Chalder; Ali R G Shaw; William Hollingworth; Chris Metcalfe; Jonathan Richard Benger; Sarah Purdy Journal: BMJ Open Date: 2017-08-01 Impact factor: 2.692