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

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Abstract

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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Authors and Affiliations

  1. Graduate School of Public Health, Yonsei University, Seoul, South Korea

    Eun-Hye Joo

  2. Department of General Surgery and Internal Medicine, College of Medicine, Yonsei Cancer Center, Institute of Cancer Research, Yonsei University, Seoul, South Korea

    Sun-Young Rha

  3. Department of Internal Medicine, College of Medicine, Yonsei Cancer Center, Institute of Cancer Research, Yonsei University, Seoul, South Korea

    Joong Bae Ahn

  4. Graduate School of Public Health, Institute of Health Services Research, Yonsei University, 134 Shinchon-Dong, Seodaemun-Gu, Seoul, 120-752, South Korea

    Hye-Young Kang

Authors
  1. Eun-Hye Joo
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  2. Sun-Young Rha
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  3. Joong Bae Ahn
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  4. Hye-Young Kang
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Corresponding author

Correspondence to Hye-Young Kang.

Additional information

Eun-Hye Joo, M.S. contributed to the design of the study, developed the survey questionnaire, and collected and analyzed data.

Sun Young Rha, M.D. and Joong Bae Ahn, M.D contributed to clinical aspects of the study and reviewed the draft manuscript.

Hye-Young Kang, Ph.D. contributed to the design of the study, developed the survey questionnaire, interpreted the study results, and prepared the manuscript.

The English in this document has been checked by at least two professional editors, both native speakers of English. For a certificate, see: http://www.textcheck.com/certificate/wNekTw

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Joo, EH., Rha, SY., Ahn, J.B. et al. Economic and patient-reported outcomes of outpatient home-based versus inpatient hospital-based chemotherapy for patients with colorectal cancer. Support Care Cancer 19, 971–978 (2011). https://doi.org/10.1007/s00520-010-0917-7

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  • DOI: https://doi.org/10.1007/s00520-010-0917-7

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