scholarly journals Cost-effectiveness of home-based care of febrile neutropenia in children with cancer

2021 ◽  
Author(s):  
Michelle Tew ◽  
Richard De Abreu Lourenco ◽  
Joshua Gordon ◽  
Karin Thursky ◽  
Monica Slavin ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Febrile Neutropenia ◽  
Low Risk ◽  
Hospital Treatment ◽  
Decision Analytic Model ◽  
Children With Cancer ◽  
Patient Level ◽  
Home Based ◽  
Intravenous Antibiotics ◽  
Home Based Care

INTRODUCTION Home-based treatment of low-risk febrile neutropenia (FN) in children with cancer with oral or intravenous antibiotics is safe and effective. There are limited data on the economic impact of this model of care. We evaluated the cost-effectiveness of implementing a low-risk FN program, incorporating home-based intravenous antibiotics, in a tertiary pediatric hospital. METHODS A decision analytic model was constructed to compare costs and outcomes of the low-risk FN program, with usual in-hospital treatment with intravenous antibiotics. The program included a clinical decision rule to identify patients at low-risk for severe infection and home-based eligibility criteria using disease, chemotherapy and patient-level factors. Health outcomes (quality-of-life) and probabilities of FN risk classification and home-based eligibility were based on prospectively collected data. Patient-level costs were extracted from hospital records. Cost-effectiveness was expressed as the incremental cost per quality-adjusted life year (QALY). FINDINGS The mean healthcare cost of home-based FN treatment in low-risk patients was A$7,765 per patient compared to A$20,396 for in-hospital treatment (mean difference A$12,632 (95% CI,12,496-12,767)). Overall, the low-risk FN program was the dominant strategy, being more effective (0.0011 QALY (95% CI,0.0011-0.0012)) and less costly. Results of the model were most sensitive to proportion of children eligible for home-based care program. CONCLUSION Compared to in-hospital FN care, the low-risk FN program is cost-effective, with savings arising from cheaper cost of caring for children at home. These savings could increase as more patients eligible for home-based care are included in the program.

scholarly journals Cost‐effectiveness of home‐based care of febrile neutropenia in children with cancer

2021 ◽  
Author(s):  
Michelle Tew ◽  
Richard De Abreu Lourenco ◽  
Joshua Robert Gordon ◽  
Karin A. Thursky ◽  
Monica A. Slavin ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Febrile Neutropenia ◽  
Children With Cancer ◽  
Home Based ◽  
Home Based Care

scholarly journals Home-based care of low-risk febrile neutropenia in children—an implementation study in a tertiary paediatric hospital

2020 ◽  
Author(s):  
Gabrielle M. Haeusler ◽  
Lynda Gaynor ◽  
Benjamin Teh ◽  
Franz E. Babl ◽  
Lisa M. Orme ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Low Risk ◽  
Implementation Study ◽  
Paediatric Hospital ◽  
Home Based ◽  
Home Based Care

Home-Based Pediatric Cancer Care: Perspectives and Improvement Suggestions From Children, Family Caregivers, and Clinicians

2021 ◽  
pp. OP.20.00958
Author(s):  
Lindsay A. Jibb ◽  
Julie Chartrand ◽  
Tatenda Masama ◽  
Donna L. Johnston
Keyword(s):  
Family Caregivers ◽  
Pediatric Cancer ◽  
Cancer Care ◽  
Care Center ◽  
System Level ◽  
Pediatric Care ◽  
Children With Cancer ◽  
Key Informants ◽  
Home Based ◽  
Home Based Care

PURPOSE: Although the hospital remains the dominant site for delivering most pediatric cancer care, home-based care is increasingly provided. To effectively deliver comprehensive, relevant, and acceptable care in children's homes, the voices of these key informants must be considered. We examined the views of children with cancer, their family caregivers, and clinicians on home-based cancer care to identify necessary strategies to improve the delivery of care. METHODS: Children with cancer, their family caregivers, and multiprofessional clinicians who provide care at a tertiary pediatric care center or in the community participated in audio-recorded, semistructured interviews in French and English. Interviews were conducted until data saturation in each participant group was achieved. Interviews were transcribed, coded, and analyzed using thematic analysis. RESULTS: Thirteen children, 20 family caregivers, and 22 clinicians participated. Home-based care was endorsed as a means to improve child health-, family social- and financial-, and system-level outcomes. The success of a home-based model is built on care that addresses child and family informational, treatment and care, material, and psychosocial needs. Mechanisms to improve care include enhanced homecare agency-hospital-family communication, training for homecare nurses in pediatric cancer care, virtual solutions, and an expanded breadth of services provided in-home. Child-, family-, and system-related factors affect the delivery of optimal home-based care. CONCLUSION: Children, families, and clinicians value a model of pediatric cancer care that incorporates home-based services. The insights of these key informants should be reflected in the principles that become the basis of home-based cancer care best practices.

Cost-effectiveness of Outpatient Management for Febrile Neutropenia in Children With Cancer

PEDIATRICS ◽  
2011 ◽  
Vol 127 (2) ◽  
pp. e279-e286 ◽  
Author(s):  
O. Teuffel ◽  
E. Amir ◽  
S. M. H. Alibhai ◽  
J. Beyene ◽  
L. Sung
Keyword(s):  
Cost Effectiveness ◽  
Febrile Neutropenia ◽  
Outpatient Management ◽  
Children With Cancer

Home-based versus hospital-based care for serious mental illness

1998 ◽  
Vol 172 (6) ◽  
pp. 506-512 ◽  
Author(s):  
Martin R. J. Knapp ◽  
Isaac M. Marks ◽  
Jane Wolstenholme ◽  
Jennifer K. Beecham ◽  
Jack Astin ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Standard Care ◽  
Cost Effective ◽  
Controlled Study ◽  
Sample Attrition ◽  
Home Based ◽  
The Difference ◽  
Randomised Controlled ◽  
The Cost ◽  
Home Based Care

BackgroundThe Daily Living Programme (DLP) offered intensive home-based care with problem-centred case management for seriously mentally ill people facing crisis admission to the Maudsley Hospital, London. The cost-effectiveness of the DLP was examined over four years.MethodA randomised controlled study examined cost-effectiveness of DLP versus standard in/out-patient hospital care over 20 months, followed by a randomised controlled withdrawal of half the DLP patients into standard care. Three patient groups were compared over 45 months: DLP throughout the period, DLP for 20 months followed by standard care, and standard care throughout. Bivariate and multivariate analyses were conducted (the latter to standardise for possible inter-sample differences stemming from sample attrition and to explore sources of within-sample variation).ResultsThe DLP was more cost-effective than control care over months 1–20, and also over the full 45-month period, but the difference between groups may have disappeared by the end of month 45.ConclusionsThe reduction of the cost-effectiveness advantage for home-based care was perhaps partly due to the attenuation of DLP care, although sample attrition left some comparisons under-powered.

scholarly journals Cost-Effectiveness Analysis of Hospitalization and Home-Based Care Strategies for People Living with HIV/AIDS: The Case of Zimbabwe

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Senelani D. Hove-Musekwa ◽  
Farai Nyabadza ◽  
Hermane Mambili-Mamboundou ◽  
Christinah Chiyaka ◽  
Zindoga Mukandavire
Keyword(s):  
Cost Effectiveness ◽  
Intervention Strategy ◽  
Intervention Strategies ◽  
Epidemiological Model ◽  
Transmission Model ◽  
People Living With Hiv ◽  
Home Based ◽  
Living With Hiv ◽  
Home Based Care ◽  
Hiv Aids

The model of care of people living with HIV/AIDS (PLWHA) has shifted from hospital care to community home-based care (CHBC) because of shortage of space in hospitals and lack of resources. We evaluate the costs and benefits of home-based care and other HIV/AIDS intervention strategies in Zimbabwe, using an interdisciplinary approach which weaves together the techniques of an epidemic transmission model and economic evaluation concepts. The intervention strategies considered are voluntary counselling and testing (VCT), VCT combined with hospitalization (H), VCT combined with CHBC, and all the interventions implemented concurrently. The results of the study indicate that implementing all the strategies concurrently is the most cost-effective, a result which also agrees with the epidemiological model. Our results also show that the effectiveness of a strategy in the epidemiological model does not necessarily imply cost-effectiveness of the strategy and behaviour change, modelled by the parameters p and m, that accompanied the strategies, influencing both the cost-effectiveness of an intervention strategy and dynamics of the epidemic. This study shows that interdisciplinary collaborations can help in improving the accuracy of predictions of the course and cost of the epidemic and help policy makers in implementing the correct strategies.

Cost-effectiveness of home-based vs. in-hospital treatment of paediatric tuberculous meningitis

2018 ◽  
Vol 22 (10) ◽  
pp. 1188-1195
Author(s):  
S. L. van Elsland ◽  
S. I. van Dongen ◽  
J. E. Bosmans ◽  
H. S. Schaaf ◽  
R. van Toorn ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Tuberculous Meningitis ◽  
Hospital Treatment ◽  
Home Based
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