Impact on health care consumption of an experimental daycare intervention

The purpose of the present study was to assess the impact on health care utilization of a controlled intervention programme for geriatric daycare patients. Sixty-five patients referred to daycare were allocated to an intervention and control group respectively. The 12-week programme was added to the ordinary daycare agenda and was designed in active collaboration with the patients in order to counteract passivity and enhance active patient involvement. Evaluations were made before and after 6 and 12 weeks of intervention, as well as 3 and 9 months after the conclusion of the programme. No extra resources were allocated to either the intervention or the control group. During the intervention period there were no changes in the utilization of home care for either group during the whole study period. Noticeably, there was a significant difference in the number of patients readmitted to hospital between the intervention and control groups (13/33 and 21/32 respectively). There was also a significant difference in favour of the intervention group concerning mean length of hospital stay (22.1 and 61.9 days respectively). The mean corresponding saving for each 12-week intervention patient during a one-year follow-up was calculated at 57,500 SEK. Even if our calculations are tentative and do not cover all aspects of the total cost, they indicate the importance of further studies of elderly patients discharged from daycare units and institutional settings.