HOSPITAL AT HOME AND CONVENTIONAL HOSPITA LIZATION - AN ECONOMIC-EVALUATION

BACKGROUND: To carry out an economic evaluation of hospital at home (H H) vs. conventional hospitalization (CH) from the hospital cost perspe ctive. METHODS: A minimization cost analysis were performed in 2 group s of patients (HH: 148 patients, 1,776 days of care; CH: 148 patients, 1,113 days) with similar characteristics. We used cost per hospital e pisode (only for the comparable period in HH and HC) and cost per day as outcome measures. The costs of health care professionals, pharmacy, sanitary matherial, diagnostic and therapeutic tests and transport we re directly estimated for each patient. Other costs were indirectly as signed from the hospital accountability information system. RESULTS: T he average episode cost at home was 172,043 ptas. (about $1,300) less compared to the conventional hospitalization. Cost per diem for HH was 25,565 ptas. less than CH. Marginal costs were 14,987 and 2,913 ptas. minor in HH than CH, per episode and day respectively. When we consid er HH staff as a differential cost (i.e. to establish a new hospital a t home unit with new staff) marginal cost per episode was 2,276 peseta s higher than CH. CONCLUSIONS: HH is a cost-effective option when deci sions take into account the average cost (establishment of a new unit vs. a new ward) or when the HH unit is created as a substitute service through the conversion of pre-existent resources. However, HH is a di savantaged cost option when it is created as an additional resource.