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Economic and patient-reported outcomes of outpatient home-based versus inpatient hospital-based chemotherapy for patients with colorectal cancer

 Eun-Hye Joo  ;  Sun-Young Rha  ;  Joong Bae Ahn  ;  Hye-Young Kang 
 SUPPORTIVE CARE IN CANCER, Vol.19(7) : 971-978, 2011 
Journal Title
Issue Date
Aged ; Antineoplastic Agents/economics* ; Antineoplastic Agents/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/economics ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Colorectal Neoplasms/drug therapy* ; Colorectal Neoplasms/economics ; Cost-Benefit Analysis ; Female ; Fluorouracil/economics ; Fluorouracil/therapeutic use ; Focus Groups ; Health Surveys ; Home Care Services/economics* ; Home Care Services/statistics & numerical data ; Humans ; Inpatients/statistics & numerical data* ; Leucovorin/economics ; Leucovorin/therapeutic use ; Male ; Middle Aged ; Multivariate Analysis ; Organoplatinum Compounds/economics ; Organoplatinum Compounds/therapeutic use ; Outpatients/statistics & numerical data* ; Patient Satisfaction/statistics & numerical data ; Regression Analysis ; Republic of Korea ; Self Report/economics* ; Statistics as Topic ; Surveys and Questionnaires
Chemotherapy ; Colorectal cancer ; Cost ; Home infusion therapy ; Outcome ; Patient satisfaction
PURPOSE: This study aims to compare the economic- and patient-reported outcomes between outpatient home-based and inpatient hospital-based chemotherapy in advanced colorectal cancer patients. METHODS: A total of 80 patients from Severance Hospital in Seoul, Korea, who had stage III colorectal cancer and underwent home-based (n = 40) or hospital-based chemotherapy (n = 40) with a FOLFOX regimen between January 2007 and April 2008 were enrolled. Patient satisfaction data were collected by a self-administered questionnaire survey. Based on hospital charge records, average cost (in 2008 Korean won (KW)) per chemotherapy session was estimated and compared between home- and hospital-based chemotherapy from a societal perspective. RESULTS: Patients receiving chemotherapy at home showed higher satisfaction with their treatment (mean satisfaction score 3.58 ± 0.15, 5-point Likert-type scale, with a higher score indicating higher satisfaction) than did those treated at the hospital (3.23 ± 0.21; p < 0.01). After adjusting for differences in baseline characteristics between the two groups using multivariate analysis, those receiving home-based chemotherapy still showed significantly higher satisfaction than those undergoing hospital-based therapy (β = 0.271, p < 0.001). Additionally, home-based therapy reduced the cost per chemotherapy session by 16.6%, compared with hospital-based treatment (1,694,216 versus 2,030,383 KW, 1,200 KW ≈ 1 US dollar). The largest cost reduction was attributable to medical costs (-201,122 KW), followed by caregiver's opportunity costs (-135,000 KW). CONCLUSIONS: Higher satisfaction and lower economic cost for home-based chemotherapy suggests that home-based chemotherapy could be a popular and cost-effective treatment option for colorectal cancer patients who are eligible for home-based chemotherapy
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
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