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Health Serv Res. 1986 February; 20(6 Pt 2): 851–880.
PMCID: PMC1068911

The effectiveness and cost of home care: an information synthesis.


The effect of home care on patient outcomes and costs of care has been controversial. This information synthesis summarizes results from studies of home care using experimental or quasi-experimental designs, explicitly including judgments of methodologic soundness in weighing the results. In 12 studies of programs targeted at chronically ill populations, home care services appear to have no impact on mortality, patient functioning, or nursing home placements. Across studies, these services either have no effect on hospitalization or tend to increase the number of hospital days; ambulatory care utilization may be increased by 40 percent. The cost of care either is not affected or is actually increased by 15 percent. The critical need at present is for better-designed studies to test the effects of different types of home care, targeted at various types of patients, on the outcomes assessed in the existing studies, as well as on other important outcomes such as family finances, quality of life, and quality of care.

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Selected References

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  • Brickner PW, Janeski JF, Rich G, Duque T, Starita L, LaRocco R, Flannery T, Werlin S. Home maintenance for the home-bound aged. A pilot program in New York City. Gerontologist. 1976 Feb;16(1 PT1):25–29. [PubMed]
  • Somers AR, Moore FM. Homemaker services--essential option for the elderly. Public Health Rep. 1976 Jul-Aug;91(4):354–359. [PMC free article] [PubMed]
  • Dunlop BD. Expanded home-based care for the impaired elderly: solution or pipe dream? Am J Public Health. 1980 May;70(5):514–519. [PubMed]
  • Kane RL, Kane RA. Care of the aged: old problems in need of new solutions. Science. 1978 May 26;200(4344):913–919. [PubMed]
  • Kane RL, Kane RA. Alternatives to institutional care of the elderly: beyond the dichotomy. Gerontologist. 1980 Jun;20(3 Pt 1):249–259. [PubMed]
  • Katz S, Hedrick SC, Henderson NS. The measurement of long-term care needs and impact. Health Med Care Serv Rev. 1979 Spring;2(1):1–21. [PubMed]
  • Hedrick SC, Katz S, Stroud MW., 3rd Patient assessment in long-term care: is there a common language? Aged Care Serv Rev. 1980;2(4):1–19. [PubMed]
  • BAKST HJ, MARRA EF. Experience with home care for cardiac patients. Am J Public Health Nations Health. 1955 Apr;45(4):444–450. [PubMed]
  • Bryant NH, Candland L, Loewenstein R. Comparison of care and cost outcomes for stroke patients with and without home care. Stroke. 1974 Jan-Feb;5(1):54–59. [PubMed]
  • Mitchell JB. Patient outcomes in alternative long-term care settings. Med Care. 1978 Jun;16(6):439–452. [PubMed]
  • Nielsen M, Blenkner M, Bloom M, Downs T, Beggs H. Older persons after hospitalization: a controlled study of home aide service. Am J Public Health. 1972 Aug;62(8):1094–1101. [PubMed]
  • Weissert WG, Wan TT, Livieratos BB, Pellegrino J. Cost-effectiveness of homemaker services for the chronically ill. Inquiry. 1980 Fall;17(3):230–243. [PubMed]
  • Katz S, Akpom CA. A measure of primary sociobiological functions. Int J Health Serv. 1976;6(3):493–508. [PubMed]
  • Chalmers TC, Smith H, Jr, Blackburn B, Silverman B, Schroeder B, Reitman D, Ambroz A. A method for assessing the quality of a randomized control trial. Control Clin Trials. 1981 May;2(1):31–49. [PubMed]
  • DerSimonian R, Charette LJ, McPeek B, Mosteller F. Reporting on methods in clinical trials. N Engl J Med. 1982 Jun 3;306(22):1332–1337. [PubMed]
  • Freiman JA, Chalmers TC, Smith H, Jr, Kuebler RR. The importance of beta, the type II error and sample size in the design and interpretation of the randomized control trial. Survey of 71 "negative" trials. N Engl J Med. 1978 Sep 28;299(13):690–694. [PubMed]

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