Background: This paper compares the cost efficacy of care at an intermediate level in a community hospital or a conventional prolonged treatment in a general hospital.
Material and methods: 142 patients older than 60 years and admitted to the city general hospital (due to an acute illness or exacerbation of a chronic disease) were randomised to one of the two types of care. Patients were followed for one year or until death and costs for care were monitored.
Results: Mean costs for treatment of the disease in question at the time of inclusion were 39,650 NOK (95% CI 30,996-48,304) in the community hospital group and 73,417 NOK (95 % CI 52,992-93,843) in the general hospital group (p < 0.01). No significant differences were found for the municipality and general hospital care costs during follow-up, except for readmissions. Mean health service costs per patient per observed day were 606 NOK (95% CI 450-761) for the community hospital group and 802 NOK (95 % CI 641-962) for the general hospital group (p = 0.03).
Interpretation: Care at an intermediate level in a community hospital in Trondheim was given for a lower cost compared to that given in a general hospital. The main reason for the difference was the reduction in readmission costs.