[Elderly patients in hospital or in an intermediate nursing home department--cost analysis]

This paper compares the cost efficacy of care at an intermediate level in a community hospital or a conventional prolonged treatment in a general hospital.

142 patients older than 60 years and admitted to the city general hospital (due to an acute illness or exacerbation of a chronic disease) were randomised to one of the two types of care. Patients were followed for one year or until death and costs for care were monitored.

Mean costs for treatment of the disease in question at the time of inclusion were 39,650 NOK (95% CI 30,996-48,304) in the community hospital group and 73,417 NOK (95 % CI 52,992-93,843) in the general hospital group (p < 0.01). No significant differences were found for the municipality and general hospital care costs during follow-up, except for readmissions. Mean health service costs per patient per observed day were 606 NOK (95% CI 450-761) for the community hospital group and 802 NOK (95 % CI 641-962) for the general hospital group (p = 0.03).

Care at an intermediate level in a community hospital in Trondheim was given for a lower cost compared to that given in a general hospital. The main reason for the difference was the reduction in readmission costs.