PT - JOURNAL ARTICLE AU - Jones, Jeremy AU - Wilson, Andrew AU - Parker, Hilda AU - Wynn, Alison AU - Jagger, Carol AU - Spiers, Nicky AU - Parker, Gillian TI - Economic evaluation of hospital at home versus hospital care: cost minimisation analysis of data from randomised controlled trial AID - 10.1136/bmj.319.7224.1547 DP - 1999 Dec 11 TA - BMJ PG - 1547--1550 VI - 319 IP - 7224 4099 - http://www.bmj.com/content/319/7224/1547.short 4100 - http://www.bmj.com/content/319/7224/1547.full SO - BMJ1999 Dec 11; 319 AB - Objectives: To compare the costs of admission to a hospital at home scheme with those of acute hospital admission. Design: Cost minimisation analysis within a pragmatic randomised controlled trial. Setting: Hospital at home scheme in Leicester and the city's three acute hospitals. Participants: 199 consecutive patients assessed as being suitable for admission to hospital at home for acute care during the 18 month trial period (median age 84 years). Intervention: Hospital at home or hospital inpatient care. Main outcome measures: Costs to NHS, social services, patients, and families during the initial episode of treatment and the three months after admission. Results: Mean (median) costs per episode (including any transfer from hospital at home to hospital) were similar when analysed by intention to treat—hospital at home £2569 (£1655), hospital ward £2881 (£2031), bootstrap mean difference −305 (95% confidence interval −1112 to 448). When analysis was restricted to those who accepted their allocated place of care, hospital at home was significantly cheaper—hospital at home £2557 (£1710), hospital ward £3660 (£2903), bootstrap mean difference −1071 (−1843 to −246). At three months the cost differences were sustained. Costs with all cases included were hospital at home £3671 (£2491), hospital ward £3877 (£3405), bootstrap mean difference −210 (−1025 to 635). When only those accepting allocated care were included the costs were hospital at home £3698 (£2493), hospital ward £4761 (£3940), bootstrap mean difference −1063 (−2044 to −163); P=0.009. About 25% of the costs for episodes of hospital at home were incurred through transfer to hospital. Costs per day of care were higher in the hospital at home arm (mean £207 v £134 in the hospital arm, excluding refusers, P<0.001). Conclusions: Hospital at home can deliver care at similar or lower cost than an equivalent admission to an acute hospital.