The value of admission avoidance: cost-consequence analysis of one-year activity in a consolidated service.
Background: Many advantages of hospital at home (HaH), as a modality of acute care, have been highlighted, but controversies exist regarding the cost-benefit trade-offs. The objective is to assess health outcomes and analytical costs of hospital avoidance (HaH-HA) in a consolidated service with over...
| Publicado en: | Cost Effectiveness & Resource Allocation Vol. 22; no. 1; pp. 1 - 10 |
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| Autores principales: | , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
BioMed Central
4/15/2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=176610131&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 176610131 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14787547 1CL9 jtl: Cost Effectiveness & Resource Allocation issn: 14787547 maglogo: N pubinfo: dt: 4/15/2024 vid: 22 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 176610131 176610131 176610131 10.1186/s12962-024-00536-1 176610131 ppf: 1 ppct: 9 formats: tig: atl: The value of admission avoidance: cost-consequence analysis of one-year activity in a consolidated service. aug: au: Hernandez, Carme Herranz, Carme Baltaxe, Erik Seijas, Nuria González-Colom, Rubèn Asenjo, Maria Coloma, Emmanuel Fernandez, Joaquim Vela, Emili Carot-Sans, Gerard Cano, Isaac Roca, Josep Nicolas, David affil: Hospital at Home Unit, Hospital Clínic de Barcelona. Villarroel, 170, 08036, Barcelona, Spain sug: subj: Patient Admission Home Health Care Hospitalization Health Care Costs Evaluation Treatment Duration Human Male Health Care Delivery Spain Retrospective Design Emergency Service Hospital Mortality Readmission Health Services Implementation Science Transitional Care Descriptive Statistics Funding Source Male ab: Background: Many advantages of hospital at home (HaH), as a modality of acute care, have been highlighted, but controversies exist regarding the cost-benefit trade-offs. The objective is to assess health outcomes and analytical costs of hospital avoidance (HaH-HA) in a consolidated service with over ten years of delivery of HaH in Barcelona (Spain). Methods: A retrospective cost-consequence analysis of all first episodes of HaH-HA, directly admitted from the emergency room (ER) in 2017–2018, was carried out with a health system perspective. HaH-HA was compared with a propensity-score-matched group of contemporary patients admitted to conventional hospitalization (Controls). Mortality, re-admissions, ER visits, and direct healthcare costs were evaluated. Results: HaH-HA and Controls (n = 441 each) were comparable in terms of age (73 [SD16] vs. 74 [SD16]), gender (male, 57% vs. 59%), multimorbidity, healthcare expenditure during the previous year, case mix index of the acute episode, and main diagnosis at discharge. HaH-HA presented lower mortality during the episode (0 vs. 19 (4.3%); p < 0.001). At 30 days post-discharge, HaH-HA and Controls showed similar re-admission rates; however, ER visits were lower in HaH-HA than in Controls (28 (6.3%) vs. 34 (8.1%); p = 0.044). Average costs per patient during the episode were lower in the HaH-HA group (€ 1,078) than in Controls (€ 2,171). Likewise, healthcare costs within the 30 days post-discharge were also lower in HaH-Ha than in Controls (p < 0.001). Conclusions: The study showed higher performance and cost reductions of HaH-HA in a real-world setting. The identification of sources of savings facilitates scaling of hospital avoidance. Registration: ClinicalTrials.gov (26/04/2017; NCT03130283). pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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