Community hospitals are a long established component of healthcare provision in England, and their potential to provide intermediate care has been recognised. But previous health economic studies of community hospital care have been methodologically weak and difficult to interpret.
So researchers compared the cost effectiveness of post-acute care at a community hospital and a district general hospital in Yorkshire, England. They identified 220 patients (average age 85 years) needing rehabilitation after an acute illness that required admission to hospital. 141 patients were randomised to a community hospital and 79 patients were randomised to an elderly care department in a district general hospital.
The health of each patient was measured at the start of the study, one week after discharge, and three and six months after randomisation. These measures were used to calculate a quality of life score. Health and social care costs for each patient were also calculated.
At six months, the average quality of life score was marginally (but non-significantly) higher for the community hospital group than for the district general hospital group. The average costs per patient were similar for the community hospital and district general hospital groups (£7233 v £7351).
Further analyses were carried out to test the robustness of these results, but they did not alter the overall findings. "These results suggest that a locality based community hospital is as cost effective as a district general hospital for post acute care of older people," conclude the authors.
MEDICA.de; Source: British Medical Journal