A PROSPECTIVE, CONTROLLED EVALUATION OF HOME CHEMOTHERAPY FOR CHILDREN WITH CANCER

Objectives. Infusion of chemotherapy at home provides an alternative t o hospitalization for children with cancer. Few programs of pediatric home chemotherapy have been described or evaluated. The purpose of thi s work was to compare prospectively chemotherapy in the hospital to ch emotherapy at home with respect to billed medical charges, out-of-pock et expenses, and quality of life. Methods. Eligibility criteria for ho me therapy were defined. Parents and nurses were trained. Billed charg es, loss of wages, out-of-pocket expenses, medical outcome, and qualit y of life of 14 patients for one course of chemotherapy in the hospita l were compared with those for an identical course at home. Results. D aily charges for chemotherapy were $2329 +/- 627 in the hospital and $ 1865 +/- 833 at home; out-of-pocket costs, $68 +/- 31 and $11 +/- 6, r espectively; and loss of income, $265 +/- 233 and $67 +/- 107, respect ively. 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 ch emotherapy at home results in lower billed charges, reduced expenses, reduced loss of income for parents, and a more satisfying lifestyle fo r patients and parents.