Cost-Effectiveness of a Barcelona Home Care Program for Individuals with Multimorbidity

To improve the efficiency and effectiveness of care and optimize healthcare resources, a home healthcare program was created for individuals with multiple chronic conditions. Demographic and clinical characteristics of the 261 individuals (mean age 84) included in the program from its inception in 2011 through 2013 (mean stay in the program 203 +/- 192days) were prospectively analyzed. The number of hospital admissions, length of stay, and costs for individuals admitted to the program were compared for two time periods: the 6months before admission to the program and their stay in the program. After admission to the program, the number of hospital admissions and the hospital length of stay per person per month decreased from 0.36 +/- 0.21 to 0.19 +/- 0.52 (P<.001) and from 3.5 to 1day (P<.001), respectively. Surveys of randomly selected patients and caregivers showed high satisfaction with the program. Costs per person per day decreased from Euro54.65 (US$73.12) to Euro17.91 (US$23.96), a reduction of 67.1%. Fewer admissions and shorter hospital stays enabled the hospital to eliminate one acute bed for every 50 individuals admitted to the program. In conclusion, home care for individuals with chronic illness with multimorbidity reduced the number of hospital admissions and length of stay, resulting in good patient satisfaction and lower costs.