Hollander Analytical Services Ltd, Victoria, BC, Canada.
Can J Aging. 2007;26 Suppl 1:149-61. doi: 10.3138/cja.26.suppl_1.149.
This paper reports on the results of analyses using administrative data from British Columbia for 10 years from fiscal 1987/1988 to 1996/1997, inclusive, to examine the comparative costs to government of long-term home care and residential care services. The analyses used administrative data for hospital care, physician care, drugs, and home care and residential long-term care. Direct comparisons for cost and utilization data were possible, as the same care-level classification system is used in BC for home care and residential care clients. Given significant changes in the type and/or level of care of clients over time, a full-time equivalent client strategy was used to maximize the accuracy of comparisons. The findings suggest that, in general, home care can be a lower-cost alternative to residential care for clients with similar care needs. The difference in costs between home care and residential care services narrows considerably for those who change their type and/or level of care, and home care was found to be more costly than long-term institutional care for home care clients who died. The findings from this study indicate that with the appropriate substitution for residential care services, in a planned and targeted manner, home care services can be a lower-cost alternative to residential long-term care in integrated systems of care delivery that include both sets of services.
本文报告了对不列颠哥伦比亚省 1987/1988 财政年度至 1996/1997 财政年度十年间的行政数据进行分析的结果，旨在比较长期家庭护理和住院护理服务对政府的相对成本。分析使用了医院护理、医生护理、药物、家庭护理和住院长期护理的行政数据。由于在不列颠哥伦比亚省，家庭护理和住院护理客户使用相同的护理水平分类系统，因此可以对成本和利用数据进行直接比较。鉴于客户的护理类型和/或水平随时间发生重大变化，采用了全职等效客户策略，以最大限度地提高比较的准确性。研究结果表明，一般来说，对于具有相似护理需求的客户，家庭护理可以作为住院护理的低成本替代方案。对于那些改变护理类型和/或水平的人来说，家庭护理和住院护理服务之间的成本差异大大缩小，对于那些因死亡而离开家庭护理的客户来说，家庭护理比长期机构护理的成本更高。本研究的结果表明，在包括这两种服务的综合护理提供系统中，以有计划和有针对性的方式适当替代住院护理服务，家庭护理可以成为住院长期护理的低成本替代方案。
