Cost-effectiveness of Veterans Administration Hospital-Based Home Care

Cummings, Joan; Hughes, Susan L.; Weaver, Frances M.; Manheim, Larry M.; Nash, Karen; Braun, Barbara I.; Adelman, Jill

doi:10.1001/archinte.1990.00390180092017

Cited by 83 publications

(18 citation statements)

References 3 publications

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“…While the latter two measures provide only an unweighted score, the Caregiver Quality of Life Instrument was used to generate "care-related" QALY estimates for carers. Of the remaining studies, two used measures of carers' free time [40,49], two used willingness to pay [47,58], and two used a mix of clinical questionnaires on health, hope, morale, and satisfaction [32,34] as outcome measures. Outcomes for carers and patients were summed together, in either the base-case or sensitivity analysis, on six occasions [31,39,42,47,48,57].…”

Section: Methods Of Incorporating Informal Carementioning

confidence: 99%

“…Just over half of all the studies were in the field of mental and behavioral disorders (of which 11 looked at interventions for dementia [35-37,39 -41,44,47,49,57,58]. In addition, two studies covered mixed populations of old or chronically ill individuals that were likely to include care of individuals with mental health problems [32,34]. Of the remaining 12 studies, 4 related to infectious diseases, 4 to cardiovascular diseases, 2 to diseases of the eye, 1 to respiratory disease, and 1 to cancer.…”

Section: Characteristics Of Studies Incorporating Informal Carementioning

confidence: 99%

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The Inclusion of Informal Care in Applied Economic Evaluation: A Review

2012

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Theory and methods development around informal care are yet to significantly permeate the applied literature; however, the results suggest that some funding priorities may change if they were to do so. The development of 1) a reference case for including informal care; 2) sensitivity analysis for contentious issues; and 3) a statement for the reason for excluding informal care, if this is deemed appropriate, may help to improve the way that informal care is included in economic evaluations in the future.

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Section: Methods Of Incorporating Informal Carementioning

confidence: 99%

Section: Characteristics Of Studies Incorporating Informal Carementioning

confidence: 99%

The Inclusion of Informal Care in Applied Economic Evaluation: A Review

2012

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“…A number of primary care pilot projects were pioneered at VA medical centers in the 1980s and early 1990s (43,46,99,100,202,203), but only ∼10% of VA health care users were enrolled in primary care at the end of fiscal year (FY) 1994. Most VA medical centers did not have any primary care programs at this time.…”

Section: Establishment Of Veterans Integrated Service Networkmentioning

confidence: 99%

Extreme Makeover: Transformation of the Veterans Health Care System

Kizer¹,

Dudley

2009

Annu. Rev. Public Health

152

130

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The veterans health care system administered by the U.S. Department of Veterans Affairs (VA) was established after World War I to provide health care for veterans who suffered from conditions related to their military service. It has grown to be the nation's largest integrated health care system.As the system grew, a number of factors contributed to its becoming increasingly dysfunctional. By the mid-1990s, VA health care was widely criticized for providing fragmented and disjointed care of unpredictable and irregular quality, which was expensive, difficult to access, and insensitive to individual needs.Between 1995 and 1999, the VA health care system was reengineered, focusing especially on management accountability, care coordination, quality improvement, resource allocation, and information management. Numerous systemic changes were implemented, producing dramatically improved quality, service, and operational efficiency. VA health care is now considered among the best in America, and the VA transformation is viewed as a model for health care reform.

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“…2 3 Findings also included higher patient and caregiver satisfaction with care for the HaH care group. [2][3][4] Among disabled veterans, improvements in cognitive functioning 6 months after discharge were shown. For patients with a terminal illness, no differences were found in survival, activities of daily living, cognitive functioning, or morale between groups.…”

Section: Commentarymentioning

confidence: 99%

“Hospital at home” care was generally as effective as routine hospital care for older adults

Messecar

1999

Evid Based Nurs

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Richards SH, Coast J, Gunnell DJ, et al QuestionIs "hospital at home" (HaH) care as effective and cost effective as inpatient hospital care for medically stable elderly patients? DesignRandomised controlled trial (RCT) with 3 months follow up. SettingHospital wards and their catchment areas in Bristol, UK. Patients241 of 383 older adults (median age 79 y, 69% women) who were in hospital and medically stable. Inclusion criteria were availability of staff, expected positive rehabilitation, need for further hospital care if a HaH programme was not available, suitable home situation, agreement from the general practitioner (GP), and expected hospital stay of 1-28 days. Exclusion criterion was waiting for nursing home placement.

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Cost-effectiveness of Veterans Administration Hospital-Based Home Care

Cited by 83 publications

References 3 publications

The Inclusion of Informal Care in Applied Economic Evaluation: A Review

The Inclusion of Informal Care in Applied Economic Evaluation: A Review

Extreme Makeover: Transformation of the Veterans Health Care System

“Hospital at home” care was generally as effective as routine hospital care for older adults

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