A cost/benefit analysis of both general and oncologic Day-Hospital (D-H) activity in the Pediatric Clinic of Trieste has been performed. Three years of activity, one immediately before and two after the beginning of the service, have been considered. For each period we have evaluated: total number of D-H admissions and traditional admissions in the ward, the number of first visits and subsequent controls, and the residence of the patients (outside or inside the province) and the average days of hospitalisation. Qualitative analysis was performed with respect to the indication for hospital admission (simple criteria for usefulness were established) and as to the outcome the problem was totally or partially solved?). The average cost of the service was calculated on the basis of laboratory and instrumental examinations concerning the general D-H, and on the basis of examinations and drugs administered to the patients in relation to the oncology D-H. The total number of hospital admissions as well as the total number of first visits did not substantially change in the three years under consideration, whereas the number of traditional admissions in the ward diminished. The average length of hospitalisation (ward + D-H) diminished from 3.6 to 2.9 days, whereas the average of days of hospitalisation in the ward increased from 3.6 to 5.4, due to the almost exclusive utilisation of the ward for severe illnesses. The decrease of the average length of hospitalisation was not due to an higher number of admissions for a single patient, since the length of stay for a single patient is still very low: 4.3 days. These data do not show hyperutilisation of D-H: 'useless' admissions passed from 23% to 4% in the general ward and from 37% to 23% in D-H. The general D-H can be considered a service with a good outcome, since 85% of the problems were solved. Expenses for the staff did not increase in the period under consideration and the cost for general D-H service per day (about 21000 liras) and for the oncologic D-H service per day (about 52000 liras) appear reasonable (the higher cost for the oncologic D-H service is mainly due to the redundance of examinations required in order to follow the multicentric protocols).
|Translated title of the contribution||Seven years of Day-Hospital service; a cost/benefit analysis|
|Number of pages||7|
|Journal||Rivista Italiana di Pediatria|
|Publication status||Published - 1982|
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health