The cost of a Homecare Package in place of hospital admission for frail older people

Healthcare Improvement Scotland’s ihub supported cost analysis of the introduction of a Homecare Package, an intervention designed to address the delay in hospital discharge for older people with frailty.

Introduction of the Homecare Package meant that frail older people could be discharged to go home, whereas they would have otherwise been admitted to a geriatric ward.

The Homecare Package, supplied by a third sector provider, was offered to 87 patients during the 10 week assessment period. Duration of support varied across individuals, ranging from one to three weeks.

Cost of the Homecare Package

To help support decision making on the continuation of the Homecare Package, the ihub’s Evidence and Evaluation for Improvement Team (EEvIT) carried out a cost analysis to evaluate the cost of the Homecare Package versus hospital admission.

The Homecare Package included in-home support and care across a period of time suitable to the patient’s recovery. Data on duration and frequency of support were collected for each of the patients offered the Homecare Package, which was then combined with the hourly cost of support (£15) to calculate a cost for each patient’s care package. Aggregating these data showed that the total cost of this intervention was £17,816 over the 10 week period.

Cost of avoided hospital admission

The duration of Homecare support for each patient was used as a proxy for the number of days that an individual would have otherwise spent in hospital – based on ihub expert opinion.  However, this assumption was conservatively capped at 12 days – the average length of hospital stay for this patient group. The reason for the capped-day approach was to offset the likelihood that Homecare support may appropriately tail off and individuals may have been discharged from hospital by that point.

Taking into consideration that the daily inpatient costs at this time was £345, EEvIT calculated that the potential resources savings from avoided hospital admissions for these patients equated to £283,360over the 10 week period

Comparing these two costs revealed that an estimated £265,544 was the overall potential resource saving as a result of the Homecare Package intervention.


No. of patients

Total cost

Homecare Package



Hospital stay costs






The Homecare Package has provided an opportunity for older people with frailty to recover in a more homely setting, in the comfort of their community and surrounding. The resource savings identified here reflect the potential opportunity cost associated with the intervention – through the freeing up of hospital beds.