The Cost-Effectiveness of Homecare Services for Adults and Older Adults: A Systematic Review

Abstract

This study provides an overview of the literature on the cost-effectiveness of homecare services compared to in-hospital care for adults and older adults. A systematic review was performed using Medline, Embase, Scopus, Web of Science, CINAHL and CENTRAL databases from inception to April 2022. The inclusion criteria were as follows: (i) (older) adults; (ii) homecare as an intervention; (iii) hospital care as a comparison; (iv) a full economic evaluation examining both costs and consequences; and (v) economic evaluations arising from randomized controlled trials (RCTs). Two independent reviewers selected the studies, extracted data and assessed study quality. Of the 14 studies identified, homecare, when compared to hospital care, was cost-saving in seven studies, cost-effective in two and more effective in one. The evidence suggests that homecare interventions are likely to be cost-saving and as effective as hospital. However, the included studies differ regarding the methods used, the types of costs and the patient populations of interest. In addition, methodological limitations were identified in some studies. Definitive conclusions are limited and highlight the need for better standardization of economic evaluations in this area. Further economic evaluations arising from well-designed RCTs would allow healthcare decision-makers to feel more confident in considering homecare interventions.

Association Between States’ Certificate of Need Laws and Home Health Care Access in the US

“…Another limitation is that the proxies used in measuring agency performance are limited to utilization due to variables available in selected datasets, restricting the interpretation of financial-related indicators. Several cost-effectiveness studies have provided insights into the financial matter, suggesting that home care interventions are likely to be cost-saving and as effective as hospital (Curioni et al, 2023). Another limitation is that the data were aggregated to the organization level, which restricts insights from the beneficiary's level; still, this study's objective is to evaluate institutions' performance considering their regulatory environment.…”

Evaluating the influence of primary healthcare nurse practitioners' interventions in home care on hospitalizations and emergency department transfers

“…Internationally, ever increasing demand for home care services over the last few decades is primarily attributed to the ageing population and the high prevalence of chronic illnesses. 1 Home care services are provided by interprofessional teams including medical, nursing, social, physical therapy and other providers. 2 Despite a growing supply of home care services, 3 many patients report having unmet or only partially met needs.…”

“…Home care includes a wide range of services designed to prevent, delay, or replace long-term or acute care while enabling people to live at home. 6 Receiving home care has been associated with several positive outcomes, such as reduced hospitalization and transfer to the emergency department (ED), 1,7 mortality, [8][9][10] and healthcare costs, 1,11 and improved quality of life. 12,13 Home care services are typically provided by interprofessional teams in private homes and assisted living facilities in the community.…”

A Preliminary Virtual Study on the Feasibility of Transferring Muscular Activation Pattern Behaviors of Psychomotor Exercises

“…This requirement implies the development of innovative, smart, and portable systems that can be installed in the limited space of a home environment and the intelligent functionalities (e.g., fast setup, easy application) of which even out the inexperience of the final users (e.g., promoting user-friendly solutions). On the other hand, the economic budget and the rent policy, which strictly depends on the country's regulations of (private and public) healthcare services, should be taken into consideration [22]. A feasible home-care therapy system has to be low-cost, and, generally speaking, it should be lent to the patient by the healthcare provider.…”