Hospital based Home Care Program, for technology depended children. Its benefit for the Health Care System

Abstract

Background: Technology Depended Children (TDC) are frequently admitted to the hospital with significant cost for the Health Care System. Home care programs have been reported to reduce admissions and consequently the health care cost. Aim: The aim of this study was to evaluate the cost of care of TDC who entered a Hospital based Home Care Program. Patients and Methods: Children with chronic respiratory problems who are technology dependent entered prospectively in a hospital based home care program. The program was covered by two nurses and two physiotherapists who visited homes on a regular weekly basis and are referred to a tertiary Paediatric Department. We calculate the cost, the days of planned admissions and planned visits, the days of unplanned admissions in the Paediatric Department and PICU, one year ago and one year after their entry in the program. Results: 40 children entered the study. Mean age was 6, 07 years. (20/40 with gastrostomy, 18/40 with tracheostomy and 14/40 on mechanical ventilation). The mean number of scheduled visits were 2. 67 before and 3.15 after (p= 0,153). Mean number of unplanned admissions were 1. 67 before and 0.97 after (p= 0, 011). Mean days of hospitalization were 42.25 one year before and 11.35 one year after (p Conclusion: Implementation of the Hospital based Home Care program for TDC significantly reduced admissions and almost halved the cost of care for these children.