Oterino-de-la-Fuente D, Peiró S, Ridao M, Marchan C
Instituto de Investigación en Servicios de Salud, Valencia, Spain.
Int J Qual Health Care. 1998 Aug;10(4):331-8. doi: 10.1093/intqhc/10.4.331.
To analyse the variations in diagnostic and therapeutic intensity in patients with similar clinical conditions depending on whether they had hospitalization at home (HH) or remained in conventional hospitalization (CH).
Observational study of two patient cohorts (HH and CH) selected prospectively.
University Hospital in the Valencia Health Service network, and the Hospital at Home Unit that it administers.
One hundred and forty-eight consecutive patients admitted to a Hospital at Home Unit, and 148 patients (matched by age, sex, disease group and hospital department) who remained in hospital in spite of fulfilling clinical criteria for HH as assessed by the nurses who normally evaluate suitability of admission to HH.
Number and cost of diagnostic tests, and cost of drugs and nursing materials per hospitalization in HH and CH.
The average number of tests for admission was significantly lower at home than in hospital (HH, 0.89; CH, 3.53); this translated into significant differences in the average diagnostic cost per hospitalization (HH, Pesetas 131; CH, Pesetas 3.316; US$1 approximately 130 Pesetas in 1994). Expenditures on drugs per episode (HH, Pesetas 7028; CH, Pesetas 16684) was also lower at home, but the differences were not significant for this or for expenditure for nursing materials (HH, Pesetas 3329; CH, Pesetas 2556).
Although some limitations of the study do not make it possible to establish unequivocal conclusions, the results point to the existence of different diagnostic and therapeutic patterns in HH and CH, which translate into significant differences in hospitalization costs.
分析临床状况相似的患者因在家住院（HH）或仍在传统住院（CH）而导致的诊断和治疗强度差异。
对两个前瞻性选择的患者队列（HH和CH）进行观察性研究。
巴伦西亚卫生服务网络中的大学医院及其管理的家庭医院病房。
连续148例入住家庭医院病房的患者，以及148例（按年龄、性别、疾病组和医院科室匹配）尽管符合家庭医院住院临床标准但仍住院的患者，这些标准由通常评估家庭医院住院适宜性的护士进行评估。
HH和CH中每次住院的诊断检查数量和费用、药物费用和护理材料费用。
在家住院时入院检查的平均数量显著低于医院（HH，0.89；CH，3.53）；这导致每次住院的平均诊断费用存在显著差异（HH，131比塞塔；CH，3316比塞塔；1994年1美元约等于130比塞塔）。每次发作的药物支出（HH，7028比塞塔；CH，16684比塞塔）在家也较低，但此项差异以及护理材料支出差异（HH，3329比塞塔；CH，2556比塞塔）均不显著。
尽管该研究存在一些局限性，无法得出明确结论，但结果表明HH和CH存在不同的诊断和治疗模式，这导致住院费用存在显著差异。
