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Pediatric tele–home care compared to usual care: cost-minimization analysis

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dc.contributor.author Adroher i Mas, Cristina
dc.contributor.author Esposito Català, Candela
dc.contributor.author Batlle Boada, Astrid
dc.contributor.author Casadevall Llandrich, Ricard
dc.contributor.author Millet Elizalde, Marta
dc.contributor.author García García, Juan José
dc.contributor.author del Castillo Rey, Manel
dc.contributor.author García Cuyàs, Francesc
dc.contributor.author Pons Serra, Miquel
dc.contributor.author López Seguí, Francesc, 1991-
dc.date.accessioned 2023-11-27T11:28:24Z
dc.date.available 2023-11-27T11:28:24Z
dc.date.issued 2023
dc.identifier.citation Adroher C, Esposito C, Batlle A, Casadevall R, Millet M, García JJ, et al. Pediatric tele–home care compared to usual care: cost-minimization analysis. JMIR Pediatr Parent. 2022 Jan-Mar;5(1):e31628. DOI: 10.2196/31628
dc.identifier.issn 2561-6722
dc.identifier.uri http://hdl.handle.net/10230/58381
dc.description.abstract Background: Although home hospitalization has been a well-known and widespread practice for some time in the adult population, it has not been the same case in the pediatric setting. Simultaneously, telemedicine tools are a facilitator of the change in the health care model, which is increasingly focused on home care. In a pioneering way in Spain, the in-home hospitalization program of the Hospital Sant Joan de Déu in Barcelona allows the child to be in their home environment at the time they are being monitored and clinically followed by the professionals. Besides being the preferred option for families, previous experience suggests that pediatric home hospitalization reduces costs, primarily thanks to savings on the structural cost of the stay. Objective: The aim of this study is to compare the average cost of a discharge by tele–home care with the usual care and to analyze the main drivers of the differential costs of both care models. Methods: A cost-minimization analysis is conducted under a hospital’s perspective, based on observational data, and estimated retrospectively. A historical control group of similar patients in terms of clinical casuistry to children hospitalized at home was used for comparison. Results: A 24-hour stay at the hospital costs US $574.19, while the in-home hospitalization costs US $301.71 per day, representing a saving of almost half (48%) of the cost compared to usual care. The main saving drivers were the personnel costs (US $102.83/US $284.53, 35.5% of the total), intermediate noncare costs (US $6.09/US $284.53, 33.17%), and structural costs (US $55.16/US $284.53, 19.04%). Home hospitalization involves a total stay 27.61% longer, but at almost half the daily cost, and thus represents a saving of US $176.70 (9.01%) per 24-hour stay. Conclusions: The cost analysis conducted under a hospital perspective shows that pediatric tele–home care is 9% cheaper compared to regular hospital care. These results motivate the most widespread implementation of the service from the point of view of economic efficiency, adding to previous experiences that suggest that it is also preferable from the perspective of user satisfaction.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher JMIR Publications
dc.relation.ispartof JMIR Pediatrics and Parenting. 2022 Jan-Mar;5(1):e31628
dc.rights © Cristina Adroher Mas, Candela Esposito Català, Astrid Batlle Boada, Ricard Casadevall Llandrich, Marta Millet Elizalde, Juan José García García, Manel del Castillo Rey, Francesc García Cuyàs, Miquel Pons Serra, Francesc López Seguí. Originally published in JMIR Pediatrics and Parenting (https://pediatrics.jmir.org), 20.01.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Pediatrics and Parenting, is properly cited. The complete bibliographic information, a link to the original publication on https://pediatrics.jmir.org, as well as this copyright and license information must be included.
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title Pediatric tele–home care compared to usual care: cost-minimization analysis
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.2196/31628
dc.subject.keyword Cost analysis
dc.subject.keyword Pediatric tele–home care
dc.subject.keyword Home care service
dc.subject.keyword Health economics
dc.subject.keyword Telehealth
dc.subject.keyword Economic evaluation
dc.subject.keyword Telemedicine
dc.subject.keyword Pediatric
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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