Home hospitalization in children and youth with special health care needs (cyshcn): financial perspectives in hospital de alta complexidad, Chile

Hospitalización domiciliaria en niños y adolescentes con necesidades especiales de atención en salud (NANEAS): perspectivas financieras en hospital de alta complejidad, Chile

Abstract

Introduction. The absence of home hospitalization (HH) of children and youth with special health care needs (CYSHCN) generates prolonged hospitalizations in closed care (CC). Objective: To compare the estimated cost of HH of high complexity CYSHCN versus the actual cost of the same patient in CC and its impact on hospital production. Methods: Descriptive and comparative study between costs of both hospitalization modalities of high complexity CYSHCN. From January to December 2016, non-oncological CYSHCN hospitalizations were registered by the Pediatric Service (PS) according to the Ministry of Health-Chile (MINSAL) norm. It was classified for clinical groups and similar consumption of resources according to groups related to diagnosis (DRG). The stay was adjusted, and financial analysis of both modalities (CC) and (HH) was performed to evaluate the impact on hospital production. Results: Of 3690 discharges, 126 (3.4%) were related to 27 CYSHCN, the average age was 4.6 years (± 5 SD) with technological dependencies to live. The mean CYSHCN stay was 16 days, compared with 5.9 for patients without special health needs. CYSHCN stays reached 2017 days (8.6%). Disregarding the CYSHCN discharges would have contributed 320 additional discharges, and his HH would have saved US $ 15 / day per patient, which for the total number of stays consumed would have been an annual saving of US $ 29170. Conclusion: HH has an estimated cost lower than the CA of high complexity CYSHCN, improves hospital productivity, and frees critical beds with financially viable investment.