Cost-effectiveness of home care versus hospital care among stroke patients from January 1998 to January 1999
- Author:
Andres Myla
;
Espallardo Noel
- Publication Type:Journal Article
- MeSH:
Human;
Aged;
Middle Aged;
Adult;
HOME CARE SERVICES;
COST-BENEFIT ANALYSIS;
STROKE
- From:
The Filipino Family Physician
2000;38(1):9-15
- CountryPhilippines
- Language:English
-
Abstract:
Background: Stroke is a leading cause of morbidity and mortality not only in our country but in other countries as well imposing a substantial economic burden on individuals and society overall. The financial cost of stroke is considerable but few cost effectiveness studies are available to guide clinical practice. It is the aim of this research then to provide comparison of cost-effectiveness or cost-benefit in stroke care to cast new light on which methods are better than others.
Objectives: To compare cost-effectiveness of Home care versus Hospital care program in stroke patients age 35-70 years old at General Hospital from January 1998 to January 1999.
Perspective: The study was done in a program perspective for the General Hospital.
Methods: A decision analysis based on available published information was formulated. The probable outcomes were 1) probability of survival, 2) probability of good quality of life, 3) probability of poor quality of life and 4) probability of mortality after 1 year. Effectiveness measure was evaluated as the product of 1 year survival and good quality of life for both home care and hospital-based care. The cost of each branch was then divided by these 2 outcomes. The cost-effectiveness was compared between the 2 alternative programs.
Results: The probability of 1 year survival for home care is 0.84 while in hospital care, probability was higher at 0.87. The probability of dying from stroke in 1 year for home care was .16 while only 0.13 was noted in hospital care. It is apparent that hospital care is more effective than home care alternative. In contrast to the results of the decision analysis, the cost-effectiveness of home care was P56,900.45 per stroke patient with good quality of life in contrast to hospital care which was higher at P65,291.70 per stroke patient with good quality of life. Although hospital-based care was more effective, incremental analysis showed that the cost of the advantage was P669,462.
Conclusion: Hospitals are more effective than home care based on probability analysis while cost-effectiveness analysis favors the home care alternative.
