Moving healthcare closer to home: financial impacts

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This paper is part of a suite of materials developed to support providers and commissioners who are making decisions about schemes to move care currently provided in acute hospitals to community-based settings. The paper presents key findings on the costs of delivering care through these schemes, compared to delivering care in an acute setting. To make the comparison, the study has modelled the potential effect on cost expenditure of four established types of scheme that deliver healthcare closer to home: telehealth schemes; enhanced step-up schemes; rapid response and early supported discharge schemes; and reablement services. The findings relate to a typical suburban local health economy over five years. The four types of scheme aim either to divert acutely unwell patients from being admitted into an acute hospital, to speed up their discharge or to reduce their ongoing care needs. Key findings include: in the long run, the costs of delivering care in the community may be lower than those of delivering care in acute hospitals; movements in cost and demand mean schemes are likely to be more important for avoiding future costs than for yielding immediate savings; these schemes are one important tool in the wider toolkit for addressing hospital financial and operational challenges; and the schemes will still need to be well designed to be cost-effective. (Edited publisher abstract)

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economic evaluation, cost effectiveness, hospital discharge, hospital admission, prevention, reablement, community care, telehealth, integrated care, older people;
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