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Friday, 21 July 2006 10:15
BNN: British Nursing News Online · www.bnn-online.co.uk
Community hospital care as cost-effective as regular hospital care
After research showed there was little difference in cost, doubts have been raised over the move to push care out of hospitals and into the community.

A team from Bradford's St Luke's Hospital looked at the rehabilitation of 220 elderly patients after illness.

The team compared the cost effectiveness of post-acute care at a community hospital and a district general hospital in Yorkshire, England.

They identified 220 patients (average age 85 years) needing rehabilitation after an acute illness that required admission to hospital. 141 patients were randomised to a community hospital and 79 patients were randomised to an elderly care department in a district general hospital.

The health of each patient was measured at the start of the study, one week after discharge, and three and six months after randomisation. These measures were used to calculate a quality of life score. Health and social care costs for each patient were also calculated.

At six months, the average quality of life score was marginally (but non-significantly) higher for the community hospital group than for the district general hospital group. The average costs per patient were similar for the community hospital and district general hospital groups (£7233 v £7351).

Further analyses were carried out to test the robustness of these results, but they did not alter the overall findings.

“These results suggest that a locality based community hospital is as cost effective as a district general hospital for post acute care of older people,” conclude the authors.

Researcher John Green said: "It raises some interesting questions, showing there is no significant cost saving with community treatment.

"However, this is just one type of treatment; there may be different results for other patients”.

Jonathan Fielden, chairman of the British Medical Association's consultants committee, said: "The Government has over hyped the cost benefits of treating people in the community.

"It is not always the cheaper options, mental health patients are an example of this.

"What we shouldn't do is have a headlong rush into pushing everything into the community, in some cases it will be for the best.

"We have to weigh up the options carefully, including the destabilising impact it will have on the hospital sector”.

A Department of Health spokesman said it was important to remember shifting care was something patients had said they wanted to see happen and was not just motivated by saving money.

And he added that the study actually showed community care was £100 cheaper and provided "an encouraging sign" that money could be saved.


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