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.