A Prospective, Controlled Evaluation of Home Chemotherapy for Children With Cancer

Abstract

Objectives. Infusion of chemotherapy at home provides an alternative to hospitalization for children with cancer. Few programs of pediatric home chemotherapy have been described or evaluated. The purpose of this work was to compare prospectively chemotherapy in the hospital to chemotherapy at home with respect to billed medical charges, out-of-pocket expenses, and quality of life. Methods. Eligibility criteria for home therapy were defined. Parents and nurses were trained. Billed charges, loss of wages, out-of-pocket expenses, medical outcome, and quality of life of 14 patients for one course of chemotherapy in the hospital were compared with those for an identical course at home. Results. Daily charges for chemotherapy were $2329 ± 627 in the hospital and $1865 ± 833 at home; out-of-pocket costs, $68 ± 31 and $11 ± 6, respectively; and loss of income, $265 ± 233 and $67 ± 107, respectively. Patients' independence, well-being, appetite, mood, and school work were significantly better at home, and parental time at work and with the family was greater. Conclusion. Administration of selected chemotherapy at home results in lower billed charges, reduced expenses, reduced loss of income for parents, and a more satisfying lifestyle for patients and parents.

Home Cancer Care Research: A Bibliometric and Visualization Analysis (1990–2021)

“…This cluster is led by three key documents. The first one is by Close et al [ 74 ], with 20 citations and Total Link Strength of 463. Administration of chemotherapy at home is a viable alternative to hospitalization for pediatric cancer patients; however, only a few home chemotherapy programs for children have been reported or reviewed in the literature.…”

Home intravenous therapy: Accessibility for Canadian children and youth

“…Other home IV therapy programs involve administration of clotting factors for hemophilia, chemotherapy, therapy for immunodeficiencies, medications for palliative care and antiinflammatory mediators (10,(17)(18)(19)(20)(21). New therapies, such as monoclonal antibodies and other biologics, will increase the need for home IV therapy in the future.…”

“…Home IV therapy has been shown to be cost saving to the health care system (14,(17)(18)(19). It is, therefore, important to ensure that it is not used inappropriately simply to achieve this end, if the patient's health could be compromised by treatment at home.…”

“…Home IV therapy for children with infections, those needing long-term parenteral nutrition (PN) and for selected other conditions is at least as effective and as safe as IV therapy in hospital (2,3,(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Home IV therapy for children provides improved quality of life, and patients and families show a preference for treatment at home (10,(17)(18)(19)(20).…”

“…Home IV therapy programs have been stimulated by the need for hospitals to control costs. With rising health care costs, children who need IV therapy alone, in the absence of other technology-dependent therapies, can be treated more economically at home (13,(17)(18)(19). Other options for outpatient IV therapy exist, such as treatment at hospital-based or free-standing clinics.…”