Hospital-at-home vs. Hospitalization, the cost-effective model: a systematic review of literature
DOI:
https://doi.org/10.29352/mill0222.31118Keywords:
hospital-at-home; classic hospitalization; cost-effectivenessAbstract
Introduction: Hospital-at-home and classic hospitalization are two models of care. The sustainability of the National Health Service is a current issue given the scarcity of resources; the implementation of home hospitalization contributes to the discussion about its economic impact.
Objective: Identify and synthesize the best available evidence on the cost and effectiveness of hospital-at-home versus classic hospitalization; identify which implementation model has the best cost-effectiveness.
Methods: Systematic Review of Literature, according to the protocol of the Joanna Briggs Institute. The selection of studies and the evaluation of their methodological quality (with instruments from the Joanna Briggs Institute) were performed by two researchers. In the initial research, 146 studies were identified, and five were included.
Results: Hospital-at-home was considered more cost-effective than classic hospitalization.
Conclusion: The evidence shows that home hospitalization is more cost-effective than classical hospitalization. However, it needs more studies covering the costs for the user/family/caregivers and economic evaluation studies with higher methodological quality.
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References
Barros, P. (2014). Plano Nacional de Saúde 2012-2016 - Roteiro de Intervenção em Sustentabilidade em Saúde. Direção Geral da Saúde. http://pns.dgs.pt/files/2014/12/2014_15_Sustentabilidade-em-saude.pdf
Berwanger, O., Suzumura, E., Buehler, A, & Oliveira, J. (2007). Como avaliar criticamente revisões sistemáticas e metanálises? Revista Brasileira de Terapia Intensiva, 19 (4), 475-480. https://www.scielo.br/pdf/rbti/v19n4/a12v19n4.pdf
Bettany-Saltikov, J. (2012). How To Do A Systematic Literature Review In Nursing: A Step-By-Step Guide: A Step-y-Step Guide. https://www.academia.edu/1913901/How_to_do_a_systematic_literature_review_in_nursing_A_step-by-step_guide
Centre for Reviews and Dissemination. (2009). Systematic Reviews- CRDS’s guidance for undertaking reviews in health care. Centre for Reviews and Dissemination - University of York. https://www.york.ac.uk/media/crd/Systematic_Reviews.pdf
Echevarria, C., Gray, J., Hartley, T., Steer, J., Miller, J., Simpson, A. J., Gibson, G. J., & Bourke, S. C. (2018). Home treatment of COPD exacerbation selected by DECAF score: A non-inferiority, randomised controlled trial and economic evaluation. Thorax, 73(8), 713–722. https://doi.org/10.1136/thoraxjnl-2017-211197
González-Ramallo, V. J., Mirón-Rubio, M., Mujal, A., Estrada, O., Forné, C., Aragón, B., & Rivera, A. J. (2017). Costs of outpatient parenteral antimicrobial therapy (OPAT) administered by Hospital at Home units in Spain. International Journal of Antimicrobial Agents, 50(1), 114–118. https://doi.org/10.1016/j.ijantimicag.2017.02.017
Ibrahim, L. F., Huang, L., Hopper, S. M., Dalziel, K., Babl, F. E., & Bryant, P. A. (2019). Intravenous ceftriaxone at home versus intravenous flucloxacillin in hospital for children with cellulitis: A cost-effectiveness analysis. The Lancet. Infectious Diseases, 19(10), 1101–1108. https://doi.org/10.1016/S1473-3099(19)30288-9
Joanna Briggs Institute. (2013). JBI Levels of Evidence. Joana Briggs Institute. https://jbi.global/sites/default/files/2019-05/JBI-Levels-of-evidence_2014_0.pdf
Joanna Briggs Institute. (2020). Joanna Briggs Institute Reviewer's Manual. Joanna Briggs Institute
Jordan, Z., Lockwood, C., Munn, Z., & Aromataris, E. (2019). The updated Joanna Briggs Institute Model of Evidence-Based Healthcare. International Journal of Evidence-Based Healthcare, 17(1), 58–71. https://doi.org/10.1097/XEB.0000000000000155
Lefebvre, C., Glanville, J., Briscoe, S., Featherstone, R., Littlewood, A., Marshall, C., Metzendorf, M-I., Noel-Storr, A., Paynter, R., Rader, T., Thomas, J., & Wieland, L. S. (2019). Searching for and selecting studies. In: Higgins J.P.T., Thomas, J., Chandler, J., & Cumpston, M. (Eds), Cochrane Handbook for Systematic Reviews of Interventions. https://www.training.cochrane.org/handbook
Lourenço, Ó., & Silva, V. (2008). Avaliação económica de programas de saúde—Essencial sobre conceitos, metodologia, dificuldades e oportunidades. Revista Portuguesa de Medicina Geral e Familiar, 24(6), Artigo 6. https://doi.org/10.32385/rpmgf.v24i6.10572
Martins, J., & Nogueira, P. (2017). Semântica da informação em saúde. Direção-Geral da Saúde. https://www.dgs.pt/portal-da-estatistica-da-saude/diretorio-de-informacao/diretorio-de-informacao/por-serie-906570-pdf.aspx?v=%3D%3DDwAAAB%2BLCAAAAAAABAArySzItzVUy81MsTU1MDAFAHzFEfkPAAAA
Muñoz, S., Takayanagui, A., Santos, C., & Sanchez-Swatman, O. (2002). Revisão sistemática de literatura e metanálise: noções básicas sobre seu desenho, interpretação e aplicação na área da saúde. Proceedings of the 8. Brazilian Nursing Communication Symposium. http://www.proceedings.scielo.br/scielo.php?script=sci_arttext&pid=MSC0000000052002000200010&lng=en&nrm=iso&tlng=pt
Ordem dos Enfermeiros. (2018). Regulamento n.º 21/2018 de 30 de janeiro. Diário da República, 2ª série, n.º 21, 3478-3487. https://www.ordemenfermeiros.pt/media/8151/regulamento-n%C2%BA-76_2018-regulamento-da-compet%C3%AAncia-acrescida-avan%C3%A7ada-em-gest%C3%A3o.pdf
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Pereira, A., & Bachion, M. (2008). Atualidades em revisão sistemática de literatura, critérios de força e grau de recomendação de evidência. Revista Gaúcha Enfermagem, 27 (4), 491. https://seer.ufrgs.br/index.php/rgenf/article/view/4633
Shepperd, S., & Iliffe, S. (2005). Hospital at home versus in-patient hospital care. The Cochrane Database Systematic Reviews (3), 1-91. https://doi.org/10.1002/14651858.CD000356.pub2
Tufanaru, C., Munn, Z., Aromataris, E., Campbell, J., & Hopp, L. (2020). Chapter 3: Systematic reviews of effectiveness. In: Aromataris, E., Munn, Z. (Eds), Joanna Briggs Institute Reviewer's Manual. Joanna Briggs Institute.
U, E. C. Y., Pryor, G. A., & Parker, M. J (2017). Hospital at home – a review of our experience. SICOT-J, 3 (60), 60. https://doi.org/10.1051/sicotj/2017047 https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC5646172&blobtype=pdf
van Elsland, S. L., van Dongen, S. I., Bosmans, J. E., Schaaf, H. S., van Toorn, R., & van Furth, A. M. (2018). Cost-effectiveness of home-based vs. In-hospital treatment of paediatric tuberculous meningitis. The International Journal of Tuberculosis and Lung Disease: The Official Journal of the International Union Against Tuberculosis and Lung Disease, 22(10), 1188–1195. https://doi.org/10.5588/ijtld.18.0236
Vianello, A., Savoia, F., Pipitone, E., Nordio, B., Gallina, G., Paladini, L., Concas, A., Arcaro, G., Gallan, F., & Pegoraro, E. (2013). «Hospital at home» for neuromuscular disease patients with respiratory tract infection: A pilot study. Respiratory Care, 58(12), 2061–2068. https://doi.org/10.4187/respcare.02501
Voudris, K., & Silver, M. (2018). Home Hospitalization for Acute Decompensated Heart Failure: Opportunities and Strategies for Improved Health Outcomes. Healthcare (Basel),6(2),31. https://doi.org/10.3390/healthcare6020031
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