Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/309944 
Year of Publication: 
2022
Citation: 
[Journal:] The European Journal of Health Economics [ISSN:] 1618-7601 [Volume:] 24 [Issue:] 8 [Publisher:] Springer [Place:] Berlin, Heidelberg [Year:] 2022 [Pages:] 1343-1355
Publisher: 
Springer, Berlin, Heidelberg
Abstract: 
Background: Providing adequate medical care to nursing home residents is challenging. Transfers to emergency departments are frequent, although often avoidable. We conducted the complex CoCare intervention with the aim to optimize nursing staff–physician collaboration to reduce avoidable hospital admissions and ambulance transportations, thereby reducing costs. Methods This prospective, non-randomized study, based on German insurance data, includes residents in nursing homes. Health care cost from a payer perspective and cost–savings of such a complex intervention were investigated. The utilisation of services after implementation of the intervention was compared with services in previous quarters as well as services in the control group. To compensate for remaining differences in resident characteristics between intervention and control group, a propensity score was determined and adjusted for in the regression analyses. Results The study population included 1240 residents in the intervention and 7552 in the control group. Total costs of medical services utilisation were reduced by €468.56 ( p  < 0.001) per resident and quarter in the intervention group. Hospital stays were reduced by 0.08 ( p  = 0.001) and patient transports by 0.19 ( p  = 0.049). This led to 1.66 ( p  < 0.001) avoided hospital days or €621.37 ( p  < 0.001) in costs–savings of inpatient services. More services were billed by general practitioners in the intervention group, which led to additional costs of €97.89 ( p  < 0.001). Conclusion The benefits of our intervention clearly exceed its costs. In the intervention group, avoided hospital admissions led to additional outpatient billing. This indicates that such a multifactorial intervention program can be cost-saving and improve medical care in long-term care homes.
Subjects: 
Claims data
Cost analysis
Secondary data
Propensity score
Complex health intervention
Nursing home residents
JEL: 
I10
H51
Persistent Identifier of the first edition: 
Creative Commons License: 
cc-by Logo
Document Type: 
Article
Document Version: 
Published Version

Files in This Item:
File
Size





Items in EconStor are protected by copyright, with all rights reserved, unless otherwise indicated.