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Economic evaluation of a geriatric day hospital: cost-benefit analysis based on functional autonomy changes
Michel Tousignant1, Réjean Hébert, Johanne Desrosiers
1Gerontology and Geriatrics Research Centre, Sherbrooke Geriatric University Institute, Quebec, Canada. michel.tousignant@usherbrooke.ca
Objective:
to investigate whether the benefits related to a geriatric day hospital programme exceeded the costs, using a cost-benefit analysis based on changes in functional autonomy.
Design:
a quasi-experimental design with a historical cohort as comparison group.
Setting:
the geriatric day hospital programme at the Sherbrooke Geriatric University Institute in the Province of Quebec, Canada.
Subjects:
151 geriatric day hospital patients.
Methods:
after admission to and at discharge from the geriatric day hospital programme, functional autonomy was assessed by a trained nurse using the Functional Autonomy Measurement System. Based on financial reports, costs associated with resources consumed at the geriatric day hospital programme by each subject were established. The benefit in dollars per day was estimated with a societal perspective through regression equations based on functional autonomy changes related to the geriatric day hospital programme. A model for spreading the benefit per day was proposed: the median time to institutionalisation or death.
Results:
for every dollar invested in the geriatric day hospital programme, the benefit for the health system was $2.14 (95% confidence interval: $1.72-$2.56).
Conclusion:
based on our sample of Sherbrooke Geriatric University Institute patients, the benefit related to the geriatric day hospital programme seems to exceed the costs.