Home-based treatment provided by nurses is a viable alternative to hospital care for heart patients, according to Australian researchers.
A study has suggested that post-discharge disease management provided at home could be a cost-effective alternative for recently-hospitalised elderly patients with chronic heart failure.
“The net benefit of home-based intervention appeared to be pronounced among the patients with a low level of self-care confidence or with fewer co-existing diseases”
It showed that specialist home care could both reduce mortality and readmissions to hospital among heart failure patients.
The study, a collaboration between Griffith University in Queensland and the Australian Catholic University in Melbourne, involved data on 280 patients at public sector hospitals.
It compared a home-based intervention delivered by specialist nurses and community-based health professionals – GPs and community pharmacists – versus the traditional clinic-based intervention delivered by a specialist clinic based in the hospital.
Intervention was provided for up to 1.5 years with median follow-up of 3.2 years.
The groups were compared in terms of total healthcare costs and quality-adjusted life-years – years of life adjusted for their quality.
“Compared with clinic-based intervention, home-based intervention is likely to be cost-effective in elderly CHF patients with significant comorbidity,” said the researchers in the International Journal of Cardiology.
Lead study author Dr Shoko Maru said a range of analysis techniques had “converged on a common conclusion” that the home-based intervention was “likely to be cost-effective”.
“The net benefit of home-based intervention appeared to be pronounced among the patients with a low level of self-care confidence or with fewer co-existing diseases,” she said.
Dr Maru said those in the home-based group lived longer and when they did require readmission their hospital stay was shorter.
She added: “Our findings inform the long-term cost-effectiveness of intervention intended for a lifelong disease such as chronic heart failure.”