Hospital at home is effective and acceptable but it's not clear whether it is cheaper

Driven by care over escalating healthcare costs, there has been increasing interest in redefining the boundaries between primary and secondary care. Hospital at home schemes are an alternative to traditional hospital care. This issue includes two randomised controlled trials of hospital at home schemes and their associated cost minimisation studies. On p 1786 Shepperd et al describe few differences in outcome between hospital at home and inpatient hospital care for five categories of patients in Northamptonshire. In general patients preferred being at home, though their carers' views were more mixed. Similarly, Richards et al found that a hospital at home scheme in Bristol was similar to routine hospital care in its clinical outcomes and acceptability to patients (p 1796). The Bristol team also found that hospital at home was cheaper: care for four patients at home costs as much as care for three in hospital (p 1802). Shepperd et al, however, found that costs were not reduced (p 1791).

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