Comparisons of the cost-effectiveness among hospital chronic care, nursing home placement, home nursing care and family care for severe stroke patients

Lian Chiu, Woei Cherng Shyu, Yu H. Liu

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Aim: This study compared the cost and effectiveness of long-term institutional care and home care for stroke patients with severe physical disabilities. Background: Whether home care is more economical or effective than institutional care for patients with chronic illnesses remains controversial when the cost of family labour is considered. Thus, decisions concerning the appropriate type of care setting for patients with severe chronic illness remain difficult. Methods: From November 1995 to March 1996, 313 hospitalized stroke patients with severe physical disabilities treated at one of five hospitals in the Taipei metropolitan area were followed from the day of hospital discharge until the third month after discharge. These 313 patients were divided into four groups as follows: (1) 106 who were admitted to a chronic care unit in a hospital, (2) 60 who were admitted to nursing homes, (3) 60 who received professional home nursing care and (4) 87 who returned home without receiving professional care. The change of physical functional status in the patient was examined as the difference between activities of daily living (ADL) scores measured at discharge and at the end of the third month after discharge. Results: Information on family costs for caregiving, including pay for long-term services utilized, labour costs for caregiving and out-of-pocket expenditures for miscellaneous materials was obtained during a weekly telephone interview. The results indicated that caring for patients in their own homes was not only more expensive but was also less effective in improving ADL scores than caring for patients in nursing homes and in chronic care units of hospitals. Conclusions: The results suggest that caring for patients with severe physical disabilities in institutions is more appropriate than caring of them at home.

Original languageEnglish
Pages (from-to)380-386
Number of pages7
JournalJournal of Advanced Nursing
Volume33
Issue number3
DOIs
Publication statusPublished - Feb 2001

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Home Nursing
Home Care Services
Nursing Care
Nursing Homes
Cost-Benefit Analysis
Stroke
Activities of Daily Living
Costs and Cost Analysis
Patient Care
Chronic Disease
Hospital Units
Long-Term Care
Health Expenditures
Interviews

Keywords

  • Cost-effectiveness analysis
  • Family care
  • Home nursing care
  • Nursing home care

ASJC Scopus subject areas

  • Nursing(all)

Cite this

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abstract = "Aim: This study compared the cost and effectiveness of long-term institutional care and home care for stroke patients with severe physical disabilities. Background: Whether home care is more economical or effective than institutional care for patients with chronic illnesses remains controversial when the cost of family labour is considered. Thus, decisions concerning the appropriate type of care setting for patients with severe chronic illness remain difficult. Methods: From November 1995 to March 1996, 313 hospitalized stroke patients with severe physical disabilities treated at one of five hospitals in the Taipei metropolitan area were followed from the day of hospital discharge until the third month after discharge. These 313 patients were divided into four groups as follows: (1) 106 who were admitted to a chronic care unit in a hospital, (2) 60 who were admitted to nursing homes, (3) 60 who received professional home nursing care and (4) 87 who returned home without receiving professional care. The change of physical functional status in the patient was examined as the difference between activities of daily living (ADL) scores measured at discharge and at the end of the third month after discharge. Results: Information on family costs for caregiving, including pay for long-term services utilized, labour costs for caregiving and out-of-pocket expenditures for miscellaneous materials was obtained during a weekly telephone interview. The results indicated that caring for patients in their own homes was not only more expensive but was also less effective in improving ADL scores than caring for patients in nursing homes and in chronic care units of hospitals. Conclusions: The results suggest that caring for patients with severe physical disabilities in institutions is more appropriate than caring of them at home.",
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