title: Cost-effectiveness of Veterans Administration hospital-based home care. A randomized clinical trial.
abstract: A randomized design was used to examine the cost-effectiveness of a Veterans Administration hospital-based home care program that case managed inpatient and outpatient care. Patients (N = 419) with two or more functional impairments or a terminal illness were randomized to hospital-based home care (n = 211) or customary care (n = 208). Functional status, satisfaction with care, and morale were measured at baseline and at 1 and 6 months after discharge from the hospital; health care utilization was tracked for 6 months. Findings included significantly higher (0.1 on a three-point scale) patient and caregiver satisfaction with care at 1 month and lower Veterans Administration and private sector hospital costs ($3000 vs $4245) for the experimental group. Net per person health care costs were also 13% lower in the experimental group. We conclude that this model of hospital-based home care is cost-effective and that its expansion to cover these two patient groups throughout the Veterans Administration system can improve patient care at no additional cost.
authors.affiliation: Health Services Research and Development Field Program, Hines (III) VA Hospital 60141.
authors.forename: J E
authors.initials: JE
authors.lastname: Cummings
authors.forename: S L
authors.initials: SL
authors.lastname: Hughes
authors.forename: F M
authors.initials: FM
authors.lastname: Weaver
authors.forename: L M
authors.initials: LM
authors.lastname: Manheim
authors.forename: K J
authors.initials: KJ
authors.lastname: Conrad
authors.forename: K
authors.initials: K
authors.lastname: Nash
authors.forename: B
authors.initials: B
authors.lastname: Braun
authors.forename: J
authors.initials: J
authors.lastname: Adelman
mesh_terms: D000368:Aged; D003258:Consumer Behavior; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D006701:Home Nursing / Q000191:economics*; D006787:Hospitals, Veterans / Q000191:economics*; D006801:Humans; D007087:Illinois; D007902:Length of Stay; D008875:Middle Aged; D015999:Multivariate Analysis; D016032:Randomized Controlled Trials as Topic