Work

Cost drivers and feasibility of a hospital-at-home programme for geriatric care in northeastern Mexico: a retrospective observational study

Year: 2025

Type: article

Abstract: OBJECTIVE: The primary objective was to evaluate factors influencing the cost of a 'hospital at home' (HAH) for geriatric patients in a Northeastern Mexican hospital. Secondarily to evaluate the per capita global cost-effectiveness compared with traditional hospital care. DESIGN: This retrospective analysis examined the costs incurred by geriatric patients in an HAH programme from February to December 2022 SETTING: We collected data from clinical records and assessed medication and procedure costs through the hospital's financial department. Costs for traditionally hospitalised patients were reviewed for comparison. PARTICIPANTS: Subjects of both genders aged 70 and older who were treated in HAH during 2022 and hospitalised subjects with the same age and gender treated in the same period. INTERVENTION: NA PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome: factors that influence costs in HAH. Secondary, global per capita cost comparison between HAH and hospital care. RESULTS: We examined the expenses associated with 416 home visits to 49 patients in the HAH programme. The main factors influencing the programme's overall cost were medical care and procedure-related disorders (β=0.333, p=0.002), sleep-regulators (β=0.561, p<0.001), laxatives (β=0.330, p=0.001) and anticoagulants (β=0.228, p=0.025). The HAH programme's per capita cost was three times lower compared with that of traditional hospital care and resulted in a 40% reduction in hospitalisation days. CONCLUSIONS: This study highlights that the main factors influencing the HAH programme's costs include medical care and procedure-related disorders, as well as medication extensively used in the elderly population. Additionally, we demonstrated the cost-effectiveness of the HAH programme, which produces substantial savings and is a financially viable alternative to traditional hospital care.

Source: BMJ Open

DOI: 10.1136/bmjopen-2024-093056