Acute admissions to a community hospital: a descriptive cost study
HERO WP 2016/9: Authors: Øystein Lappegard, Department of Hallingdal sjukestugu, Medical Clinic of Ringerike General Hospital, Vestre Viken Hospital Trust, Terje P. Hagen, Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo and Per Hjortdahl, Department of General Practice, Institute of Health and Society, University of Oslo.
Introduction: In several countries, health-care providers are searching for alternatives to hospitalization. In recent years, a practice has been established in Hallingdal, a rural region in Norway, in which patients with certain acute somatic illnesses are admitted to Hallingdal Sjukestugu (HSS), a community hospital 150 km from the nearest general hospital, Ringerike Sykehus (RS). A randomized, controlled study was carried out to compare health consequences, patient-perceived quality and health-care costs between patients acutely admitted to HSS and to RS. This paper discusses the topic of health-care costs.
Methods: Patients intended for acute admission to HSS, as an alternative to hospitalization, were included in the study. Eligible patients were randomized to two groups; admitted to HSS (n = 33), and admitted to RS (n = 27). Costs were compared between the two groups at discharge and for the 12-month follow-up.
Results: The cost of the inpatient stay at HSS was significantly lower than the cost at RS, which is explained by lower transport costs (p < 0.001) and lower costs for physicians-related work (p = 0.006). The health-care cost during the follow-up year did not differ significantly between the two groups.
Conclusions: Compared with general hospital admissions, patient admissions to a community hospital gave cost savings for a similar group of patients. In the follow-up year, there were no significant cost differences between the two groups. Generalizations of the findings should be made with caution, as the study was performed at a single institution and the number of included patients was low.
Trial registration: ClinicalTrials.gov NCT01069107. Registered 2 April 2010
Keywords: health economy, rural health care systems, patient admission, emergency health-care services, general practitioners, community hospitals.
JEL: H42, I18