A systematic review of the costs and effectiveness of different models of paediatric home care

Abstract

et al. A systematic review of the costs and effectiveness of different models of paediatric home care. Health Technol Assess 2002;6(35). Health Technology Assessment is indexed in Index Medicus/MEDLINE and Excerpta Medica/ EMBASE. Copies of the Executive Summaries are available from the NCCHTA website (see opposite). NHS R&D HTA Programme T he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS. Initially, six HTA panels (pharmaceuticals, acute sector, primary and community care, diagnostics and imaging, population screening, methodology) helped to set the research priorities for the HTA Programme. However, during the past few years there have been a number of changes in and around NHS R&D, such as the establishment of the National Institute for Clinical Excellence (NICE) and the creation of three new research programmes: Service Delivery and Organisation (SDO); New and Emerging Applications of Technology (NEAT); and the Methodology Programme. This has meant that the HTA panels can now focus more explicitly on health technologies ('health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care) rather than settings of care. Therefore the panel structure has been redefined and replaced by three new panels: Pharmaceuticals; Therapeutic Procedures (including devices and operations); and Diagnostic Technologies and Screening. The HTA Programme continues to commission both primary and secondary research. The HTA Commissioning Board, supported by the National Coordinating Centre for Health Technology Assessment (NCCHTA), will consider and advise the Programme Director on the best research projects to pursue in order to address the research priorities identified by the three HTA panels. The research reported in this monograph was funded as project number 98/05/03. The views expressed in this publication are those of the authors and not necessarily those of the HTA Programme or the Department of Health. The editors wish to emphasise that funding and publication of this research by the NHS should not be taken as implicit support for any recommendations made by the authors. Criteria for inclusion in the HTA monograph series Reports are published in the HTA monograph series if (1) they have resulted from work commissioned for the HTA Programme, and (2) they are of a sufficiently high scientific quality as assessed by the referees and editors. Reviews in Health Technology Assessment are termed 'systematic' when the account of the search, appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others.

Care closer to home for children and young people who are ill: developing and testing a model of service delivery and organization

“…International research has shown that CCTH services vary, but that they can be broadly classified by focus, location and timing of input (Parker et al. 2003).…”

Hospital‐based home care for children with cancer

“…Pediatric home care (PHC) facilitates continuation of a normal life for children and their families by reducing disruptions resulting from hospital admissions. Accordingly, provision of PHC for children with cancer, as well as for children with other acute and chronic illnesses, is increasing because of technological developments, improvements in the understanding of factors for complications, the costs of hospital‐based health care, changing policies, and the potential psychosocial advantages 5–8. There is no consensus on the definition of PHC, but PHC is in general either a community‐based service that primarily supports children with long‐term conditions, or a hospital‐based service that provides specialist care such as cancer treatment 9.…”

“…Despite the increasing provision of PHC in general, three systematic reviews of PHC have found that controlled studies are rare and that the evidence base is limited 5, 7, 9. Knowledge is sparse about the effect of PHC on the frequency of hospital admissions, length of hospital stays, children's health outcomes and quality of life (QOL), and cost effectiveness.…”

A Methodological Description of a Randomised Controlled Trial Comparing Hospital-Based Care and Hospital-Based Home Care when a Child is Newly Diagnosed with Type 1 Diabetes

“…Paediatric home care (PHC) facilitates the continuation of normal life for children and their families and is on the increase due to the potential psychosocial benefits of home care and the costs of hospital-based health care [17]. There is no consensus on the definition of PHC and the service can be based on both general and specialist schemes.…”

“…General PHC services most often work from a community base in a single district. By contrast, specialist services are more likely to be hospital-based, providing service to more than one district [17-20]. Outpatient treatment is provided by health care professionals in the outpatient clinic at the hospital while PHC provides treatment by health care professionals in the child’s home.…”