Consumer views of health care: a comparison of hospital and home care

While, Alison

doi:10.1111/j.1365-2214.1992.tb00345.x

Cited by 16 publications

(18 citation statements)

References 10 publications

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“…A validated interview schedule 7 and maximum variation sampling 8 were used, ensuring that views of all subpopulations were represented.…”

Section: Patient/carer Costs and Burdenmentioning

confidence: 99%

Economic evaluation of an acute paediatric hospital at home clinical trial

Bagust

2002

Archives of Disease in Childhood

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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 (£23.31 v £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 carers 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 carer satisfaction with care provision for sick children with appropriate conditions. I t has long been accepted that hospital admission of children should be avoided unless therapeutically necessary.1 Although Hospital at Home (HAH) schemes have been shown to provide a cost effective alternative to hospital care (HC) in some adult patients, [2][3][4][5] there is no such evidence for paediatric HAH schemes, which may merely transfer the burden of care from publicly funded health services to private and informal carers.We report results from a prospective economic evaluation of a paediatric HAH scheme compared to traditional hospital inpatient care, based on data collected as part of a randomised controlled trial. The economic evaluation addressed two questions:• Does paediatric HAH care increase costs borne by parents and their families? • Does paediatric HAH care reduce costs to the health service? METHODSDetails of patient recruitment and randomisation are reported in the accompanying paper. 6 As the principal clinical outcome (readmission rate) did not differ significantly between the trial arms, a cost minimisation analysis was undertaken. Our principal interest was the suggestion of cost shifting from the NHS to parents and families, but we also considered differences in NHS costs.Patients were recruited from three groups of children (breathing difficulties, diarrhoea/vomiting, and fever) requiring acute admission and meeting clinical suitability criteria for HAH care. Patients were further classified by time of randomisation: either immediately, or at first subsequent medical review (within 24 hours). Data collection Patient/carer costs and burdenThe level of burden experienced by carers was assessed using questionnaires on private expenditure (travel, food, phone calls, and other direct costs), and absences from paid employment. A diary card captured details of parent/carer...

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“…A validated interview schedule 7 and maximum variation sampling 8 were used, ensuring that views of all subpopulations were represented.…”

Section: Patient/carer Costs and Burdenmentioning

confidence: 99%

Economic evaluation of an acute paediatric hospital at home clinical trial

Bagust

2002

Archives of Disease in Childhood

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“…Funn viser til at barn og pårøren-de har behov for sosial omgang selv i en livskrise, og at den sosiale delen av barnets liv virker inn på barnets livskvalitet (5,(7)(8)(9)(10)(11) Behandlingen i hjemmet bidrar til økt livskvalitet for hele familien. Pleien er direkte rettet mot familien som helhet og ivaretar dermed alles behov.…”

Section: Barn På Sykehusunclassified

“…Selv uten kontinuerlig tilsyn, slik som ved en barneavdeling, opplevde foreldrene og barna trygghet. Sykepleieren hadde aldri dårlig tid, ga dem hjelp og veiledning og bidro dermed til mestring, og satte av tid til samtaler (7,8,11,(13)(14)(15)(16).…”

Section: Barn På Sykehusunclassified

“…Hjemmebasert behandling byr i større grad på familiesentrert pleie ettersom sykepleierens tid i hjemmet kun er avsatt til den enkelte pasient og hans eller hennes familie (13). Funn indikerte at pleien ga psykososial støtte for familien og at familien følte sykepleierne hadde god tid til samtale og dermed bidro til at familien følte seg ivaretatt (8,13).…”

Section: Barn På Sykehusunclassified

“…At den palliative behandlingen er bredspektret innebaerer at omsorgen i større grad omfatter hele familien. (7,8,12,13).…”

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