Effects of formal home care on hospitalizations and doctor visits

Gonçalves, Judite

doi:10.1007/s10754-016-9200-x

Cited by 19 publications

(20 citation statements)

References 30 publications

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“…Overall, the findings show that a 10% increase in per capita home care supply is associated with a 1.2%–2.1% reduction in ALOS for emergency inpatients 9 . This small, negative relationship is consistent with previous evidence from the NHS (Fernandez & Forder, 2008) and Switzerland (Gonçalves & Weaver, 2017). However, the strength of the relationship for the average hospital case, in this study and others, is not representative of the full LOS distribution, and therefore may fail to capture those patients where home care is most amenable to reducing LOS.…”

Section: Discussionsupporting

confidence: 91%

“…In this study, we examine whether home care and inpatient care are substitutes using administrative data from Ireland and, in particular, examine substitution between home care and LOS for those with long hospital stays. Two studies that most closely relate to ours look at differences in the provision of formal home care across regions and time in Switzerland (Gonçalves & Weaver, 2017) and Spain (Costa‐Font, Jimenez‐Martin, & Vilaplana, 2018). The Swiss study uses data from the Swiss Health Survey to examine home care hours supply (reimbursed by the compulsory health insurance program) and find that in those aged 65+, no significant reduction in LOS was observed in regions with more home care supply.…”

Section: Introductionmentioning

confidence: 90%

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Does formal home care reduce inpatient length of stay?

et al. 2020

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Formal home care is an appropriate substitute for acute hospital care for many older people. However, limited empirical evidence exists on the extent of substitution between the supply of home care and hospital use. This study examines whether patients from areas with a better supply of home care have lower inpatient length of stay (LOS). We link administrative data on over 300,000 public hospital inpatient admissions in Ireland between 2012 and 2015 to region-year panel data on public home care supply. In addition to modeling average LOS, we estimate unconditional quantile regressions to examine whether home care supply has a disproportionately strong impact on long LOS. We find that inpatients from areas with higher per capita home care supply have lower average LOS; a 10% increase in home care is associated with a 1.2%-2.1% reduction in LOS. This result is driven by the subset of patients with the longest LOS, likely delayed discharges. Stronger results were found for stroke and hip fracture patients, who might be expected to have higher than average propensity to use home care services, and for patients from a region that experienced an unusually large increase in home care supply.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 90%

Does formal home care reduce inpatient length of stay?

et al. 2020

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“…In possible extensions to our approach, factor analysis has a variety of potential applications in this field. For instance, it can be used to model home care policy in other countries where such policy is also decentralized, such as Canada or Switzerland (e.g., Gonçalves & Weaver, 2017; Stabile, Laporte, & Coyte, 2006). It may also be applied to measure other policies, such as nursing home policy.…”

Section: Discussionmentioning

confidence: 99%

Measuring State Medicaid Home Care Participation and Intensity Using Latent Variables

Gonçalves

Konetzka

2018

J Appl Gerontol

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Population aging and policies to redirect long-term care toward home- and community-based services have led to increases in Medicaid home care spending in most states. Changes in state Medicaid home care policy generosity may result from changes in the number of persons served (i.e., Participation) and/or changes in quantities of services covered (i.e., Intensity). This study measures state Medicaid home care Participation and Intensity comprehensively using latent variables, and uses those latent variables to describe changes in Medicaid home care policy generosity over time and across states. Yearly state-level data from the Medicaid Statistical Information System (1999-2012) are analyzed using exploratory and confirmatory factor analyses. Between 1999 and 2012, 29 states expanded both Participation and Intensity, whereas six states reduced both. In the remaining states, a trade-off occurred. Distinguishing between Medicaid home care Participation and Intensity deserves attention, as expansions along these two dimensions represent potentially different implications for beneficiaries.

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“…Cost data were based primarily on costs utilized in a 2016 Swiss cost-minimization analysis (CMA), including costs from a study on home care, hospitalizations, and doctor visits in Switzerland published by the Université de Genève ( Table 1 ). 12 , 14 Drug costs were taken from the Spezialitätenliste in February 2017 ( Table 1 ), 15 with the cost of “other SCIGs” based on IgPro20, as it is currently the most commonly used SCIG in the Swiss market. Future costs (i.e., those beyond the first year of the analysis) were not discounted, following guidelines from the International Society for Pharmacoeconomic and Outcomes Research.…”

Section: Methodsmentioning

confidence: 99%

An evaluation of the budget impact of a new 20% subcutaneous immunoglobulin (Ig20Gly) for the management of primary immunodeficiency diseases in Switzerland

Pollock¹,

Meckley²

2018

CEOR

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IntroductionWhile most individual primary immunodeficiency diseases (PID) are rare, the collective prevalence of PID results in a substantial economic and clinical burden. The aim of this study was to evaluate the budgetary implications of Ig20Gly (Immune Globulin Subcutaneous [human] 20% solution; CUVITRU®, Baxalta US Inc, now part of Shire Plc, Westlake Village, CA, USA) as a treatment for PID relative to intravenous immunoglobulin (IVIG) and other subcutaneous immunoglobulin (SCIG) formulations in the Swiss health care setting.Materials and methodsA budget impact model was developed in Microsoft Excel to capture the estimated prevalence of PID in Switzerland, the proportion of patients treated in different health care settings, and the costs of administering SCIG and IVIG in each setting. Unit costs were based on a recent cost-minimization analysis of SCIG in Lausanne, and drug costs were taken from the Spezialitätenliste. All costs were reported in 2016 Swiss Francs (CHF), and future costs were not discounted.ResultsThe total cost of treating PID in Switzerland was estimated to be CHF 11.16 m over 3 years, comprising CHF 9.28 m of drug costs and CHF 1.87 m of ancillary costs, including health care professional time and other administration costs, such as pumps and needle sets. The analysis showed that using Ig20Gly in place of other SCIG formulations would be cost neutral, while using Ig20Gly in place of IVIG would result in savings of 4.0%.ConclusionIg20Gly would be cost neutral relative to existing SCIG products and would result in cost savings relative to IVIG in patients with PID in Switzerland, even with modest uptake.

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Effects of formal home care on hospitalizations and doctor visits

Cited by 19 publications

References 30 publications

Does formal home care reduce inpatient length of stay?

Does formal home care reduce inpatient length of stay?

Measuring State Medicaid Home Care Participation and Intensity Using Latent Variables

An evaluation of the budget impact of a new 20% subcutaneous immunoglobulin (Ig20Gly) for the management of primary immunodeficiency diseases in Switzerland

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