title: Impact of long-term home care on hospital and nursing home use and cost.
abstract: This article reports the long-range impact of a long-term home care program in Chicago on hospital and nursing home use and on overall health care costs over four client-years of observation. The evaluation utilized a quasi-experimental design with a comparison group composed of clients who received home-delivered meals. The health services utilization experience of consecutively accepted treatment (N = 157) and comparison group (N = 156) subjects was monitored for 48 client-months following acceptance to care. Imputed costs were then assigned to each type of care measured. Findings include a significantly lower risk of permanent admission to sheltered and intermediate-level nursing home care in the treatment group but no difference in risk of permanent admission to skilled-level nursing home care. Despite savings in low-intensity nursing home days, preliminary findings indicate that total costs of care were 25 percent higher in the treatment group. However, these costs are accompanied by significant quality-of-life benefits in the treatment group (reported elsewhere).
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002641:Chicago; D003365:Costs and Cost Analysis; D005260:Female; D005102:Health Expenditures; D006699:Home Care Services / Q000191:economics / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008134:Long-Term Care / Q000191:economics; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*