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The costs of returning home
H C Hanger1, C Conway, R Sainsbury
1Department of Health Care of the Elderly, Princess Margaret Hospital, Christchurch.
The New Zealand Medical Journal
|September 22, 1993
Summary
Elderly patients discharged from hospital heavily utilize domiciliary support services, incurring significant out-of-pocket costs. Funding changes could increase these expenses, impacting patient access to essential care.
Area of Science:
- Geriatric Medicine
- Health Services Research
- Public Health Policy
Background:
- Elderly individuals discharged from hospital often require extensive medical and domiciliary support.
- Recent policy shifts in funding for services like the Accident Compensation Corporation (ACC) and Disabled Persons Community Welfare Act (DPCW) may affect patient costs.
Purpose of the Study:
- To quantify the utilization and patient-borne financial costs of medical and domiciliary services for elderly patients post-hospital discharge.
- To assess the impact of recent legislative and policy changes on these patient costs.
Main Methods:
- A cohort of elderly patients (n=94) discharged home from hospital were assessed 3 months post-discharge.
- Data collected included the use of medical services, pharmaceuticals, domiciliary support, and adaptive equipment, along with associated patient costs.
Main Results:
- High utilization of services was observed: 40% received meals on wheels, 64% domestic help, and 42% district nursing.
- Most patients (86%) needed walking aids, and 82% required adaptive equipment.
- The average out-of-pocket cost for the first 3 months was $541.40, with potential funding changes adding an estimated $60.38.
Conclusions:
- Elderly patients discharged from hospital are significant consumers of domiciliary support services.
- Changes in funding for these services require careful monitoring to understand effects on service utilization, patient costs, and overall health status.