To the Editor: British authors Wilson and Parker in their editorial on hospital in the home1 acknowledge the outdated Cochrane review of 20012 in relation to costs of hospital in the home. More recent research in New South Wales provides compelling evidence of cost saving in excess of 50% when community costs are compared with inpatient costs for certain diagnosis related groups.3,4 Patient selection for these services is based on safety, functional ability, carer support, and consent. The treatment regimens are based on evidence and governed by strict quality assurance. These elements form the foundations of successful acute and post-acute care programs.
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- 1 Sacred Heart Rehabilitation Centre, St Vincent’s Hospital, Darlinghurst, NSW 2010
- 2 Macarthur Health Service, Sydney, NSW. stwilsonATstvincents.com.au
- 1. Wilson AD, Parker SG. Hospital in the home: what next? Med J Aust 2005; 183: 228-229. <MJA full text>
- 2. Shepperd S. Hospital at home versus in-patient hospital care. Cochrane Database Syst Rev 2001; (3): CD000356.
- 3. Board N, Brennan N, Caplan GA. A randomised controlled trial of the costs of hospital as compared with hospital in the home for acute medical patients Aust N Z J Public Health 2000; 24: 305-311.
- 4. Wilson SF, Shorten B, Marks R. Costing the ambulatory episode: implications of total or partial substitution of hospital care. Aust Health Rev 2005; 29: 360-365.
- 5. Health Amendment Act (no.1) 2001, pursuant to section 5D of the National Health Act 1953.