A cost study of a general practitioner hospital in the Netherlands

Abstract

Objective: To perform a cost study of the first general practitioner (GP) hospital in the Netherlands.Methods: We conducted a cost study in a GP hospital in the Netherlands. Data on healthcare utilisation from 218 patients were collected for a period of one year. The costs of admission to the GP hospital were compared with the expected costs of the alternative mode of care. In the GP hospital three types of bed categories were distinguished: GP beds (admission and discharge by GPs, n=131), rehabilitation beds (recovery from hospital surgery, n=62) and nursing home beds (hospital patients awaiting a vacancy in a nursing home, n=25). GPs were interviewed to indicate the best alternative form of healthcare for the GP bed patients in the absence of a GP hospital (dichotomised for this study into ‘hospital’ or ‘home care’). For the ‘rehabilitation’ and ‘nursing home’ patients the alternative care mode was admission to a hospital.Results: The mean length of stay was 15 days for the GP beds, 31 days for the rehabilitation beds and 90 days for the nursing home beds. For the GP bed patients the costs were ϵ2533 per admission compared with ϵ3792 for hospital stay. For the group of GP bed patients for whom ‘home care’ was the best alternative, the costs were ϵ2494 for GP hospital days compared with ϵ2814, the average cost for home care of patients of 65 years and older. For rehabilitation patients the costs per patient were ϵ4744 compared with ϵ8041 in a hospital. For patients waiting for admission to a nursing home, these costs were ϵ13,143 and ϵ22,670, respectively.Conclusion: The GP hospital might be a cost-saving alternative for elderly patients in need of intermediate medical and nursing care between hospital and home care. Further research on the cost-effectiveness of the GP hospital compared with home care and nursing home care is needed.