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Health Economics Research Programme, University of Oslo HERO On line Working Paper Series

No 2016:9:
Acute admissions to a community hospital: a descriptive cost study

Øystein Lappegard, Terje P. Hagen () and Per Hjortdahl

Abstract: Introduction: In several countries, health-care providers are searching for alternatives to hospitalization. In recent years, a practice has been established in Hallingdal, a rural region in Norway, in which patients with certain acute somatic illnesses are admitted to Hallingdal Sjukestugu (HSS), a community hospital 150 km from the nearest general hospital, Ringerike Sykehus (RS). A randomized, controlled study was carried out to compare health consequences, patient-perceived quality and health-care costs between patients acutely admitted to HSS and to RS. This paper discusses the topic of health-care costs. Methods: Patients intended for acute admission to HSS, as an alternative to hospitalization, were included in the study. Eligible patients were randomized to two groups; admitted to HSS (n = 33), and admitted to RS (n = 27). Costs were compared between the two groups at discharge and for the 12-month follow-up. Results: The cost of the inpatient stay at HSS was significantly lower than the cost at RS, which is explained by lower transport costs (p < 0.001) and lower costs for physicians-related work (p = 0.006). The health-care cost during the follow-up year did not differ significantly between the two groups. Conclusions: Compared with general hospital admissions, patient admissions to a community hospital gave cost savings for a similar group of patients. In the follow-up year, there were no significant cost differences between the two groups. Generalizations of the findings should be made with caution, as the study was performed at a single institution and the number of included patients was low.

Keywords: health economy; rural health care systems; patient admission; emergency health-care services; general practitioners; community hospitals; (follow links to similar papers)

JEL-Codes: H42; I18; (follow links to similar papers)

18 pages, December 6, 2016

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