title: Home care cost-effectiveness for respiratory technology-dependent children.
abstract: We evaluated home care costs and the cost-effectiveness of home care vs alternative institutional care for respiratory technology-dependent children in a Medicaid Model Waiver Program. "Cost-savings" was measured as the difference between the established Medicaid reimbursable charges to enact an individualized care plan at a long-term care institution and the actual Medicaid reimbursements for home care. Ten patients--six dependent on mechanical ventilation and four with a tracheostomy who were receiving oxygen--were included in the analysis. The mean (+/- SD) annual home care costs were $109,836 +/- $20,781 for ventilator-dependent children and $63,650 +/- $12,350 for oxygen-dependent patients with a tracheostomy, representing annual savings of approximately $79,000 per patient and $83,000 per patient, respectively. The largest portion of home care reimbursements was for nursing care, accounting for 69.0% and 59.0% of the two patient groups. The full program (50 patients) has the potential for a savings of $4 million per year.
authors.affiliation: Department of Critical Care Medicine, Children's National Medical Center, Washington, DC 20010.
authors.forename: A I
authors.initials: AI
authors.lastname: Fields
authors.forename: A
authors.initials: A
authors.lastname: Rosenblatt
authors.forename: M M
authors.initials: MM
authors.lastname: Pollack
authors.forename: J
authors.initials: J
authors.lastname: Kaufman
mesh_terms: D002648:Child; D002662:Child Health Services / Q000191:economics*; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D006699:Home Care Services / Q000191:economics*; D006801:Humans; D007223:Infant; D008484:Medicaid; D010102:Oxygen Inhalation Therapy; D012121:Respiration, Artificial; D012138:Respiratory Therapy / Q000191:economics*; D014139:Tracheostomy; D014481:United States