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Episodic acute care costs: linking inpatient and home care
P Jacobs1, E Hall, I Henderson
1Department of Public Health Sciences, University of Alberta, Edmonton.
Study Objective:
To develop a measure of an acute care "episode of care" that incorporates hospital and home care portions of care, and to measure the costs of such episodes.
Design:
Patient level data from a home care program and an acute care hospital were linked using patient health insurance identification numbers. The linked database contained information on inpatient case mix, home care patient classification (i.e., type of care) and cost data for both settings. Data by patient classification were analyzed.
Main Results:
Patterns of resource use were very different for medical and surgical cases, home care costs being 25% of a medical episode and only 5% of a surgical episode. For surgical cases, the marginal cost of an extra surgical day is about equal to the marginal cost of an extra short-term home care case (i.e., a one-day reduction in a surgical inpatient length of stay would cover the cost of a home care stay). Medical cases would require a three-day reduction in inpatient cost.