Close P, Burkey E, Kazak A, Danz P, Lange B
Department of Pediatrics, Hershey Medical Center, PA 17033, USA.
Pediatrics. 1995 Jun;95(6):896-900.
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.
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.
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.
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.
对癌症患儿而言，在家中输注化疗药物是住院治疗之外的另一种选择。很少有儿科家庭化疗项目得到描述或评估。本研究的目的是前瞻性地比较住院化疗和家庭化疗在医疗费用账单、自付费用以及生活质量方面的差异。
明确了家庭治疗的入选标准。对家长和护士进行了培训。比较了14例患者在医院进行一个疗程化疗的费用账单、工资损失、自付费用、医疗结局以及生活质量，与在家中进行相同疗程化疗的上述各项指标。
化疗的每日费用在医院为2329±627美元，在家中为1865±833美元；自付费用分别为68±31美元和11±6美元；收入损失分别为265±233美元和67±107美元。患者在家中的独立性、幸福感、食欲、情绪和学业表现明显更好，家长的工作时间和陪伴家人的时间也更多。
在家中进行特定化疗可降低费用账单、减少开支、减少家长的收入损失，并为患者和家长带来更令人满意的生活方式。
