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. 1986 Feb;20(6 Pt 2):851–880.

The effectiveness and cost of home care: an information synthesis.

S C Hedrick, T S Inui
PMCID: PMC1068911  PMID: 3512486

Abstract

The effect of home care on patient outcomes and costs of care has been controversial. This information synthesis summarizes results from studies of home care using experimental or quasi-experimental designs, explicitly including judgments of methodologic soundness in weighing the results. In 12 studies of programs targeted at chronically ill populations, home care services appear to have no impact on mortality, patient functioning, or nursing home placements. Across studies, these services either have no effect on hospitalization or tend to increase the number of hospital days; ambulatory care utilization may be increased by 40 percent. The cost of care either is not affected or is actually increased by 15 percent. The critical need at present is for better-designed studies to test the effects of different types of home care, targeted at various types of patients, on the outcomes assessed in the existing studies, as well as on other important outcomes such as family finances, quality of life, and quality of care.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BAKST H. J., MARRA E. F. Experience with home care for cardiac patients. Am J Public Health Nations Health. 1955 Apr;45(4):444–450. doi: 10.2105/ajph.45.4.444. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Brickner P. W., Janeski J. F., Rich G., Duque T., Starita L., LaRocco R., Flannery T., Werlin S. Home maintenance for the home-bound aged. A pilot program in New York City. Gerontologist. 1976 Feb;16(1 PT1):25–29. doi: 10.1093/geront/16.1_part_1.25. [DOI] [PubMed] [Google Scholar]
  3. Bryant N. H., Candland L., Loewenstein R. Comparison of care and cost outcomes for stroke patients with and without home care. Stroke. 1974 Jan-Feb;5(1):54–59. doi: 10.1161/01.str.5.1.54. [DOI] [PubMed] [Google Scholar]
  4. Chalmers T. C., Smith H., Jr, Blackburn B., Silverman B., Schroeder B., Reitman D., Ambroz A. A method for assessing the quality of a randomized control trial. Control Clin Trials. 1981 May;2(1):31–49. doi: 10.1016/0197-2456(81)90056-8. [DOI] [PubMed] [Google Scholar]
  5. DerSimonian R., Charette L. J., McPeek B., Mosteller F. Reporting on methods in clinical trials. N Engl J Med. 1982 Jun 3;306(22):1332–1337. doi: 10.1056/NEJM198206033062204. [DOI] [PubMed] [Google Scholar]
  6. Dunlop B. D. Expanded home-based care for the impaired elderly: solution or pipe dream? Am J Public Health. 1980 May;70(5):514–519. doi: 10.2105/ajph.70.5.514. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Freiman J. A., Chalmers T. C., Smith H., Jr, Kuebler R. R. The importance of beta, the type II error and sample size in the design and interpretation of the randomized control trial. Survey of 71 "negative" trials. N Engl J Med. 1978 Sep 28;299(13):690–694. doi: 10.1056/NEJM197809282991304. [DOI] [PubMed] [Google Scholar]
  8. Hedrick S. C., Katz S., Stroud M. W., 3rd Patient assessment in long-term care: is there a common language? Aged Care Serv Rev. 1980;2(4):1, 3-19. [PubMed] [Google Scholar]
  9. Kane R. L., Kane R. A. Alternatives to institutional care of the elderly: beyond the dichotomy. Gerontologist. 1980 Jun;20(3 Pt 1):249–259. doi: 10.1093/geront/20.3_part_1.249. [DOI] [PubMed] [Google Scholar]
  10. Kane R. L., Kane R. A. Care of the aged: old problems in need of new solutions. Science. 1978 May 26;200(4344):913–919. doi: 10.1126/science.417403. [DOI] [PubMed] [Google Scholar]
  11. Katz S., Akpom C. A. A measure of primary sociobiological functions. Int J Health Serv. 1976;6(3):493–508. doi: 10.2190/UURL-2RYU-WRYD-EY3K. [DOI] [PubMed] [Google Scholar]
  12. Katz S., Hedrick S. C., Henderson N. S. The measurement of long-term care needs and impact. Health Med Care Serv Rev. 1979 Spring;2(1):1, 3-21. [PubMed] [Google Scholar]
  13. Mitchell J. B. Patient outcomes in alternative long-term care settings. Med Care. 1978 Jun;16(6):439–452. doi: 10.1097/00005650-197806000-00001. [DOI] [PubMed] [Google Scholar]
  14. Nielsen M., Blenkner M., Bloom M., Downs T., Beggs H. Older persons after hospitalization: a controlled study of home aide service. Am J Public Health. 1972 Aug;62(8):1094–1101. doi: 10.2105/ajph.62.8.1094. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Somers A. R., Moore F. M. Homemaker services--essential option for the elderly. Public Health Rep. 1976 Jul-Aug;91(4):354–359. [PMC free article] [PubMed] [Google Scholar]
  16. Weissert W. G., Wan T. T., Livieratos B. B., Pellegrino J. Cost-effectiveness of homemaker services for the chronically ill. Inquiry. 1980 Fall;17(3):230–243. [PubMed] [Google Scholar]

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