A randomised controlled trial of the costs of hospital as compared with hospital in the home for acute medical patients.
OBJECTIVE
To test the cost effectiveness of Hospital in the Home compared to hospital admission for acute medical conditions.


METHODS
Randomised controlled trial at the Prince of Wales Hospital, Sydney, from October 1995 to February, 1997; 100 patients with acute medical conditions admitted through the Emergency Department.


RESULTS
The Hospital in the Home (HITH) group costs per separation ($1,764, CI 95% $1,416-$2,111, n = 50) were significantly lower (p < 0.0001, Mann-Whitney U-Wilcoxon Rank Sum) than the control group hospital separation ($3,614, CI 95% $2,881.37-$4,347.27, n = 47) with no significant difference in clinical outcomes, and comparable or better user satisfaction.


CONCLUSIONS
Given the favourable clinical outcomes the HITH model produces at a lower cost, the cost-effectiveness of the care mode is high, and the allocative efficiency favourable.


CONCLUSIONS
As a care model and critical pathway, HITH offers hospitals real bed day savings that can either be used to rationalise resource usage for a given level of activity, or increase throughput.
Ambulatory Information Infrastructure Project, New South Wales Health, North Sydney. nboar@doh.health.nsw.gov.au
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Brennan
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Caplan
D000208:Acute Disease / Q000191:economics*; D003362:Cost-Benefit Analysis; D017050:Episode of Care; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006302:Health Services Research; D006699:Home Care Services / Q000191:economics*; D017721:Hospital Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D009517:New South Wales