The costs of returning home.
OBJECTIVE
To measure the use, and the financial cost to the patient, of medical and domiciliary services, in an elderly population following discharge from hospital. To estimate the effect of recent changes in Accident Compensation Corporation (ACC), Disabled Persons Community Welfare Act (DPCW) interpretation and user part charges on those costs.


METHODS
Elderly patients discharged home from hospital were visited 3 months following their discharge. The use of medical services and pharmaceuticals, receipt of formal domiciliary support services and adaptive equipment was recorded, together with the cost to the patient of each.


RESULTS
Ninety-four (88%) of 106 eligible patients were visited. Fifty percent lived alone and 77% were solely reliant on state benefits for income. Forty (42%) received meals on wheels, 64 (68%) domestic help and 42 (45%) district nursing. Most (86%) required the use of a walking aid and 77 (82%) needed further adaptive equipment to return home. The mean cost to the patient was $541.40 for the first 3 months. Changes in the funding of community supports would add an average of $60.38 (11.2%) to this cost.


CONCLUSIONS
Elderly patients recently discharged from hospital are high users of domiciliary support services. Any changes to their funding need monitoring to determine the effects on utilisation, costs and health status for the patient.
Hanger
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HC
Department of Health Care of the Elderly, Princess Margaret Hospital, Christchurch.
Conway
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Sainsbury
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D000359:Aftercare / Q000191:economics*; D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities / Q000331:legislation & jurisprudence; D005260:Female; D006699:Home Care Services / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D012656:Self-Help Devices / Q000191:economics; D014942:Workers' Compensation / Q000331:legislation & jurisprudence