Home care as an option in worsening chronic heart failure -- a pilot study to evaluate feasibility, quality adjusted life years and cost-effectiveness.
BACKGROUND
Worsening chronic heart failure (CHF) is largely characterized by frequent hospital admissions and the need for specialist care.


OBJECTIVE
To evaluate the feasibility of home care (HC) versus conventional care (CC) in relation to health-related quality of life (HRQL) and cost-utility in patients with worsening CHF.


METHODS
Thirty-one patients seeking medical attention at hospital for worsening CHF were randomised to HC or CC. Following discharge within 48 hours from the hospital, patients in the HC group were followed-up in their homes by a specialist nurse. Follow-ups were conducted for both groups, 1, 4, 8 and 12 months after inclusion in the study.


RESULTS
There was no significant difference in clinical events, adverse events or in HRQL. The total cost related to CHF was lower in the HC group after 12 months (p=0.05).


CONCLUSIONS
Reduction in cost of care for selected patients with CHF eligible for hospital care might be achieved by early discharge from hospital followed by home visits. Due to the small number of patients, these results must be interpreted with caution.
Patel
Harshida
H
Institute of Health and Care Sciences, Sahlgrenska Academy, Sweden. harshidaben.patel@vgregion.se
Shafazand
Masoud
M
Ekman
Inger
I
Höjgård
Sören
S
Swedberg
Karl
K
Schaufelberger
Maria
M
D000368:Aged; D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D005240:Feasibility Studies; D005260:Female; D006333:Heart Failure / Q000451:nursing*; D006699:Home Care Services / Q000191:economics; D006801:Humans; D008297:Male; D010865:Pilot Projects; D019057:Quality-Adjusted Life Years; D018709:Statistics, Nonparametric; D013548:Sweden; D016896:Treatment Outcome