texts, fact sheets, and summaries
Media releases, news coverage, and announcements
#300 - 895 Fort Street
Victoria, BC, Canada
Tel: (250) 384-2776
Fax: (250) 389-0105
Substudy 10 Fact Sheet
Economic Evaluation of a Geriatric Day Hospital : Cost-Benefit Analysis
Based on Functional Autonomy Changes (NA101-10)
This project is one of fifteen sub-studies of the National Evaluation
of the Cost-Effectiveness of Home Care Project (NA101). Pressures on the
health care system are partly due to the needs of an aging population,
and geriatric day hospital services are one response to the escalating
demand for institutional care and services. Day services have the potential
to decrease this demand by offering ambulatory treatment for elderly patients
with disabilities related to poor physical health or psychosocial impairments.
This study investigated the cost-effectiveness of a geriatric hospital
day program, using a cost-benefit analysis based on changes in functional
The sample was composed of 151 patients admitted to the Geriatric Day
Hospital (GDH) program at the Sherbrooke University Geriatrics Institute
in the Province of Québec. Data from a previous longitudinal study
tracking autonomy changes in 607 elderly people over 75 years of age living
at home were used to create a comparison group. Functional autonomy (a
means of measuring the ability to perform daily tasks) after admission
and at discharge was assessed by a trained nurse using the Système
de mesure de l'autonomie fonctionelle (SMAF). Based on financial reports,
costs associated with resources consumed by the GDH were established.
Benefits in dollars per day were estimated through regression equations
based on functional autonomy changes related to the GDH program. A scenario
for spreading the benefit per day was proposed: the median time from survival
analysis to institutionalisation or death from the comparison group.
The project leaders identified the following outcomes:
- For each dollar invested in care, $2.14 of benefits were derived
in terms of improvement in functional status.
- A measurement of dollar benefits alone does not incorporate other
important aspects for clients such as improvement in cognitive function,
socialization, and well-being. As a result, the findings of a 114 per
cent cost-benefit may in fact be the lower limit of the possible benefit
of such hospitals.
The project leaders indicated that their findings are important because,
in their view:
- The results give policy-makers more information on the economic aspects
of geriatric day hospital programs for their decisions about budget
allocations for health care for the elderly.
- Health policy-makers will need to grapple with the issue of optimal
length of stay for patients
- Too long or too short a stay may increase the costs or reduce the
- The study was conducted in the absence of a true control group, and
other studies using this methodology need to be done to determine the
benefits of day hospitals related to different interventions, or no
interventions at all.
As this was an evaluation project, please see the "Activities"
HTF Contribution to the Project:
$1,505,000 (divided among the 15 sub-studies)
Language of Report: