The Design of a Cost-Effectiveness Analysis Within a Concurrent Randomized Clinical Trial of the Hamilton-Wentworth Chronic Home Care Programme

Abstract

<p>The economic analysis described in this thesis is designed to compare two alternate approaches to post-hospital treatment for a specified group of chronically ill patients who are aged 65 and over and eligible for Home Care at the point of discharge from acute hospitals. Relative costs and health effects will be compared between the Hamilton-Wentworth are programme and the "no programme" situation or the usual of treatment without Home Care, using a cost-effectiveness model. Data will be collected from the Home Care group (experimental) and the No Home Care group (control) in a concurrent randomized clinical trial of the Home Care programme for the specified patients of interest. Costs will be measured as described herein. Health effects of interest will be physical function, social function and morale.</p> <p>The completed results of the study will provide needed information about the magnitude and distribution of costs in each programme alternative for this specific group of patients in Hamilton-Wentworth and about the relation of costs to health effects. The analysis will have relevance to the Hamilton-Wentworth programme and to the Ontario Ministry of Health, as well as planners of similar programmes for similar groups of patients and the patients themselves. The data should add to the growing body of knowledge about the economics of Home Care programmes.</p> <p>The methods developed here for measuring cost in a variety of services and for collection of health service utiIization data could be applied to other studies of similar community-based, multiservice programmes in relation to either specific patient groups or the overall programme impact. The models used for analysis and health effects within the context of a randomized trial should be applicable to other health care evaluations.</p>