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- Effectiveness of long-term health care in home context versus institutional care for the elderly dependentPublication . Fonseca-Teixeira, Susana; Parreira, Pedro; Freitas, Maria João; Mónico, Lisete; Mariano, Lorenzo; Alonso, Jose García; Amado, JoãoIntroduction: Demographic aging and changes in the epidemiological pattern have led to an increase in health expenditures, particularly long-term care. In this way, home support is pointed out as an important strategy with added benefits. Objective: This review aims to identify and synthesize scientific evidence on the health gains of long-term care in a home context versus institutional care for dependent elderly people. Method: A review of the literature published in the last 10 years in the EBSCOhost database was carried out in three languages (Portuguese, English and Spanish). The descriptors of Medical Subject Headings used were: “Nursing care”, “Health Services Accessibility”, “Long-term care”, “Home care services”, “At-home”, “Nursing home”, “Cost benefit analysis” and “Efficiency”. Results: The results indicate that home-based care may be a lower cost alternative than institutional long-term care. The focus on home-based care is also linked to improved quality of care, lower access inequalities, more equitable and accessible care, reflecting not only the health outcomes of the population but also a reduction in the total cost of health care, resulting in affordable and sustainable health outcomes. Evidence has shown that interventions by multidisciplinary teams are more efficient and home-based care users have improved health status, lower admission rates to the emergency department, faster recovery and less likely to be hospitalized for adverse events, cutaneous infections and pressure ulcers. The empowerment of patients and caregivers in the care transition has also been shown to be an effective response in reducing rehospitalization rates, reflecting lower hospital costs. On the other hand, studies indicate that the cost-effectiveness of home-based care is more effective only for less dependent elderly people and that they have access to informal caregivers. Conclusion: Cost containment of institutional care and investment in home-based care are major challenges in increasing the efficiency of long-term and continuing care expenditures as well as greater partnership with social services, allow citizens to access the care they need more quickly.