Considering the changes that have occurred in healthcare
in the last decade, in particular the emphasis on quality
of life, cost containment, and the fact that family members
have become an integral part in the home-care of
severely disabled NMD patients,20 we based our hospitalat-
home model on the idea that family caregivers could
acquire sufficient knowledge and skill to manage their
NMD relative in case of respiratory complication. Our
results show that this scheme can be effective and that
non-professional caregivers can play a critical role in the
transition of the care of NMD patients with pulmonary
exacerbation from hospital to home, providing complex
care that includes medical and nursing tasks.
In our experience, the average cost of hospital-at-home
was impressively lower than hospital care: approximately
€8,300 per patient, which is in line with previous studies
on home treatment for COPD exacerbation and stroke.21-23
In our study the cost savings are at least partially explained
by the fact that the care was largely carried out by trained
family members, reducing labor cost, which is a large
proportion of hospital cost