Cost-effectiveness of home care compared to hospital care in adults

Abstract

Objective: Evaluate and synthesize available scientific evidence on the cost-effectiveness of home nursing compared to hospitalization. Methods: The following electronic databases were used: PubMed, EMBASE, Cochrane, Web of Science, LILACS, and Google Academics. The electronic searches returned a total of 501 studies in the databases and in the complementary search, which were sorted by title and abstract. Finally, 14 studies met the inclusion and exclusion criteria: 11 randomized controlled trials and 3 cohort studies. Results: Home nursing is a viable alternative to hospital care and to reduce expenses with stable chronic patients, and it is necessary to analyze factors that may interfere with the implementation of the model, such as the willingness of caregivers to take care of patients at home and logistics of health systems. However, this review has failed to demonstrate that home nursing is less expensive than existing schemes for subgroups such as patients recovering from elective surgery or patients in need of acute care. Conclusion: The home nursing scheme can provide an economical alternative to chronic care if the operating costs of the local hospital are relatively high. It is also recommended to carry out primary studies that can evaluate home care in the context of the Unified Health System.