Home Parenteral Nutrition: a direct costs study in the approved centres of Montpellier and Strasbourg.
OBJECTIVE
Home Parenteral Nutrition (HPN) is an expensive but relatively cost effective therapy. In France, HPN has been organized around regionally located approved major centers. Few French studies have focused on the economic costs of HPN. The objective of this study was to assess the direct costs of HPN in two approved centers.


METHODS
Included patients and their nurses filled in a questionnaire in a prospective analysis. The questionnaires were complemented by data from the dispensary, the head of the institution's financial administration and different organizations. Cost were calculated according to the national health insurance fund and hospitalisation prices for 2003.


RESULTS
The direct cost was on average 83 euro per patient per day: 58% for drugs and material, 16% for hospital personnel, 16% for non-institutional caregivers, 4% for patient transportation, 4% for material transportation, and 2% for laboratory tests. The costs reimbursed by the national health insurance fund for laboratory tests, non-institutional caregivers and patient transportation were on average 18 euro per patient per day. Hospital funds provided 78% of the total costs. Daily costs were lower in Strasbourg as compared with Montpellier (62.1 vs 103.3 euro).


CONCLUSIONS
The cost of the products administered accounts for the majority of daily costs of home parenteral nutrition which is essentially funded by hospital resources. The lower daily costs per patient in Strasbourg may be related to greater patient independence.
Tu Duy Khiem-El Aatmani
Anne
A
Service Pharmacie, Hôpitaux Universitaires De Strasbourg, 67098 Strasbourg Cedex. Anne.ELAATMANI@chru-strasbourg.fr
Senesse
Pierre
P
Reimund
Jean-Marie
JM
Beretz
Laurence
L
Baumann
René
R
Pinguet
Frédéric
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004180:Direct Service Costs / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006699:Home Care Services / Q000191:economics*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics; D010288:Parenteral Nutrition / Q000191:economics*; D011446:Prospective Studies