Comparative cost analysis of home and hospital treatment

Abstract

A comparative study evaluating home and hospital treatment for terminal cancer patients is reported. Home care was provided by a comprehensive home care program, the Don Monti Home Oncology Medical Extension (H.O.M.E.). A multispecialty team including an oncologist, oncology nurse, social worker, dietitian and technologist is transported to the home in a medically-equipped van to render treatment. Services provided include physical assessments, pain control, chemotherapy and transfusion administration, psychosocial support, nutrition education and bereavement counseling. Two-hundred eighteen patients were entered of which 174 were treated at home and 44 in the hospital. Patients were comparable in age, diagnosis, sites of metastases, prior treatment and Karnofsky status. Both groups received similar supportive care either at home or in the hospital. Cost analysis of home and hospital care revealed a per diem cost benefit of $256.00 for home treatment. Comprehensive home treatment provided by a multi-specialty team can deliver effective care with medical and financial benefits to terminal cancer patients.