ABSTRACT Home‐based care has emerged as a potential alternative to traditional hospital‐based care for children and adolescents worldwide. This systematic review aimed to systematically gather and critically assess the available evidence on the cost‐effectiveness of home‐based versus in‐hospital care for pediatric populations globally. A comprehensive search was conducted across ten databases (CINAHL, Cochrane Library, CNKI, Embase, LILACS, MEDLINE/PubMed, PsycINFO, Scopus, Science Direct, and Web of Science) from inception to December 2024. Additional searches were also performed in gray literature sources and trial registries. Quantitative studies reporting full economic evaluations comparing home‐based and in‐hospital care were included. Primary outcomes comprised length of hospital stay, readmission rates, costs, productivity changes, caregiver satisfaction, and quality of life. Risk of bias was assessed using RoB 2, the Newcastle‐Ottawa Scale, and the GRACE tool. Twenty‐one studies met the inclusion criteria, encompassing 5,643 participants, including 2,161 receiving home care and 3,482 receiving hospital care. Nineteen studies (90%) reported lower costs associated with home‐based care. Randomized controlled trials demonstrated variable risk of bias, whereas cohort studies were generally classified as having high methodological quality. Nevertheless, findings should be interpreted with caution due to substantial heterogeneity across studies and variability in the quality and reporting of economic evaluations. Overall, home‐based care appears to be a promising and potentially cost‐effective alternative to hospital‐based care for both acute and chronic pediatric conditions. However, the successful implementation of home‐based care depends on caregiver readiness, logistical feasibility, and the structure and capacity of healthcare systems.
Lopes‐Júnior et al. (Thu,) studied this question.