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Economic evaluation of an acute paediatric hospital at home clinical trial
A Bagust1, A Haycox, S A Sartain
1Senior Research Fellow, Department of Pharmacology & Therapeutics, University of Liverpool,Liverpool L69 3GE, UK.
Insights
Hospital at Home (HAH) care for children with acute conditions significantly increases patient satisfaction and reduces family costs. However, it is unlikely to decrease overall National Health Service (NHS) expenses.
Area of Science:
- Pediatric Healthcare Economics
- Comparative Health Services Research
Background:
- Hospital at Home (HAH) offers an alternative to traditional inpatient care for children.
- Assessing the economic impact and patient satisfaction of HAH is crucial for healthcare planning.
Purpose of the Study:
- To compare the costs incurred by families and the National Health Service (NHS) for Hospital at Home (HAH) versus conventional inpatient care for children.
- To evaluate patient and caregiver satisfaction with HAH services.
Main Methods:
- A prospective economic evaluation using cost minimization analysis was conducted within a randomized controlled trial.
- The study included children with breathing difficulties, diarrhea and vomiting, or fever admitted to HAH or conventional care.
Main Results:
- Families experienced a 41% reduction in direct costs with HAH.
- No evidence suggested HAH shifted care burdens to parents or affected employment rates.
- Patients and caregivers strongly preferred HAH.
Conclusions:
- Pediatric HAH schemes do not appear to reduce NHS costs but do not increase family-borne expenses.
- HAH significantly enhances patient and caregiver satisfaction for suitable pediatric conditions.
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 ( pound 23.31 v pound 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 careers 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 career satisfaction with care provision for sick children with appropriate conditions.