A comparative analysis of treatment costs for home-based care and hospital-based care in enteral nutrition patients: a retrospective analysis of claims data

from Health Policy at http://bit.ly/2EVqEqD on December 29, 2018 at 11:54AM

Publication date: Available online 28 December 2018

Source: Health Policy

Author(s): M. Maeda, H. Fukuda, S. Shimizu, T. Ishizaki

Abstract
Objective

To explore the differences in mean treatment costs between home-based care and hospital-based care in enteral nutrition patients in Japan.

Methods

Using claims data from September 2013 to August 2014, we analyzed patients with recorded reimbursements for enteral nutrition at home or in a hospital. Treatment costs were compared using a panel data analysis with an individual fixed effects model that adjusted for the number of comorbidities and fiscal year. Costs were compared for all patients, as well as for specific diseases (pneumonia, sequelae of cerebrovascular disease, and dementia).

Results

The study sample comprised 7,783 patients with a cumulative total of 33,751 person-months of data. The mean patient age was 84.4 years for home-based care, 83.7 years for hospital-based care. The panel data analysis found that the cost estimates for hospital-based care were consistently higher than those for home-based care; the difference in adjusted treatment costs were $4,894 for all patients, $5,315 for pneumonia patients, $4,481 for sequelae of cerebrovascular disease patients, and $4,519 for dementia patients (all P < 0.001). Hospital-based care was still more expensive even when long-term care services were included in home-based care treatment cost estimates.

Conclusion

Home-based care was consistently and substantially cheaper than hospital-based care in enteral nutrition patients in Japan.