Oterino de la Fuente D, Ridao M, Peiró S, Marchan C
Unidad de Investigación, Hospital Virgen de la Salud, Toledo.
Med Clin (Barc). 1997 Jul 5;109(6):207-11.
To carry out an economic evaluation of hospital at home (HH) vs. conventional hospitalization (CH) from the hospital cost perspective.
A minimization cost analysis were performed in 2 groups of patients (HH: 148 patients, 1,776 days of care; CH: 148 patients, 1,113 days) with similar characteristics. We used cost per hospital episode (only for the comparable period in HH and HC) and cost per day as outcome measures. The costs of health care professionals, pharmacy, sanitary material, diagnostic and therapeutic tests and transport were directly estimated for each patient. Other costs were indirectly assigned from the hospital accountability information system.
The average episode cost at home was 172,043 ptas. (about $1,300) less compared to the conventional hospitalization. Cost per diem for HH was 25,565 ptas. less than CH. Marginal costs were 14,987 and 2,913 ptas. minor in HH than CH, per episode and day respectively. When we consider HH staff as a differential cost (i.e. to establish a new hospital at home unit with new staff) marginal cost per episode was 2,276 pesetas higher than CH.
HH is a cost-effective option when decisions take into account the average cost (establishment of a new unit vs. a new ward) or when the HH unit is created as a substitute service through the conversion of pre-existent resources. However, HH is a disadvantaged cost option when it is created as an additional resource.
从医院成本角度对居家医院（HH）与传统住院治疗（CH）进行经济评估。
对两组具有相似特征的患者进行了最小化成本分析（HH组：148例患者，1776天护理；CH组：148例患者，1113天）。我们将每次住院费用（仅针对HH和HC的可比期间）和每日费用作为结果指标。直接估算了每位患者的医疗保健专业人员、药房、卫生材料、诊断和治疗测试以及交通费用。其他费用则从医院问责信息系统中间接分配。
与传统住院治疗相比，居家平均每次住院费用少172,043比塞塔（约合1300美元）。HH的每日费用比CH少25,565比塞塔。HH的边际成本分别比CH每次住院和每日少14,987和2,913比塞塔。当我们将HH工作人员视为差异成本（即设立一个配备新员工的新居家医院单元）时，每次住院的边际成本比CH高2276比塞塔。
当决策考虑平均成本（设立新单元与新病房）时，或者当通过转换现有资源将HH单元创建为替代服务时，HH是一种具有成本效益的选择。然而，当将HH作为额外资源创建时，它在成本方面处于劣势。
