Healthcare costs and productivity losses associated with county‐based home‐care service for sick children in Sweden

Abstract

Healthcare costs and productivity losses associated with county-based home-care service for sick children in Sweden Aims: The aim of this study was to estimate the healthcare costs and productivity losses associated with countybased home-care services (HCS) for sick children. Methods: In this observational follow-up study, a combination of hospital care and HCS was compared to estimated alternative care solely at the hospital. Data on one year of healthcare utilisation for 32 children, supplied by the hospital and HCS, were collected from administrative systems. Corresponding healthcare unit prices were collected from healthcare pricelists. The human-capital approach was applied to estimate productivity losses and the value of productivity losses for 25 parents. Family characteristics, including parental work absenteeism and income, were collected by a questionnaire distributed to parents at five time points during a year. Descriptive and comparative statistics were used for analysis and carried out with ethical approval. Results: Healthcare costs for children receiving a combination of hospital care and HCS varied among children with estimated average healthcare cost savings of SEK 50 101 per child compared to the alternative of care provided only in the hospital. The reduced costs were related to children receiving nonpalliative HCS care tasks. Average annual productivity losses due to parental work absenteeism were estimated at 348 hours with an associated monetary value estimated at SEK 137 524 per parent. Conclusion: County-based HCS, provided as complement to and substitute for hospital care for ill children, does not increase healthcare cost and should be a prioritized area when organising paediatric health care. Productivity losses vary greatly among parents and are pronounced also when children receive HCS with signs of gender-related differences.

Cost-effectiveness of oral ondansetron for children with acute gastroenteritis in primary care: a randomised controlled trial

“…Differences in indirect costs were attributable to less work absence in the ondansetron group. This was particularly evident for mothers, among whom productivity losses are typically double those of fathers, and consistent with evidence that mothers stay at home more often than fathers to take care of sick children (28). In the United States, 80% of non-medical costs per case of acute gastroenteritis were shown to be attributable to missed work from parents (29).…”

“…This was particularly evident for mothers of children not receiving ondansetron, among whom productivity losses are typically double those of fathers, and consistent with evidence that mothers stay at home more often than fathers to take care of sick children. 28 In the US, 80% of non-medical costs per case of acute gastroenteritis in children were shown to be attributable to parents missing work. 29 In the CAU group in the study presented here, parental work absence accounted for 62.9% of the total costs compared to 55.7% in the ondansetron group.…”

The Childhood Cancer Centre Is Coming Home: Experiences of Hospital-Based Home Care

“…In previous research, parents experienced this as a calmer and more predictable solution, and more compatible with family life, than being forced to stay in hospital [ 4 ]. In addition, parents can often be financially affected by hospital stays [ 5 , 6 ] and home care can strengthen family life without negatively impacting on the family’s finances due to, for example, travel costs [ 5 ]. Children have also reported advantages with conducting cancer treatment at home [ 7 ].…”