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Home care cost-effectiveness for respiratory technology-dependent children
A I Fields1, A Rosenblatt, M M Pollack
1Department of Critical Care Medicine, Children's National Medical Center, Washington, DC 20010.
American Journal of Diseases of Children (1960)
|July 1, 1991
Summary
Home care for respiratory technology-dependent children in a Medicaid Model Waiver Program is cost-effective. This approach offers significant annual savings compared to institutional care, with nursing services being the primary cost driver.
Area of Science:
- Healthcare Economics
- Pediatric Respiratory Care
- Medicaid Policy
Background:
- Respiratory technology dependence in children necessitates specialized care.
- Institutional care for such patients incurs substantial costs.
- Medicaid Model Waiver Programs aim to provide cost-effective alternatives.
Purpose of the Study:
- To evaluate the cost-effectiveness of home care versus institutional care for pediatric patients dependent on respiratory technology.
- To quantify the cost savings associated with home care within a Medicaid Model Waiver Program.
Main Methods:
- Comparative cost analysis of home care and institutional care.
- Calculation of "cost-savings" based on differences in Medicaid reimbursement rates.
- Inclusion of ten pediatric patients: six ventilator-dependent and four with tracheostomy receiving oxygen.
Main Results:
- Mean annual home care costs were $109,836 for ventilator-dependent children and $63,650 for tracheostomy patients.
- Annual savings were approximately $79,000 per ventilator-dependent child and $83,000 per tracheostomy patient.
- Nursing care constituted the largest portion of home care reimbursements (69.0% and 59.0%).
Conclusions:
- Home care is a cost-effective alternative to institutional care for respiratory technology-dependent children.
- The Medicaid Model Waiver Program demonstrates significant potential for cost savings.
- The full program, serving 50 patients, could save an estimated $4 million annually.