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Home-Based Cancer Care Boosts Outcomes, Cuts Costs

Stethoscope and iPhone

(Pexels.com)

29 May 2020. An evaluation of a two year-old home care service for cancer patients shows the program reduces chances of later hospital visits and lowers overall patient costs. A team from Huntsman Cancer Institute at University of Utah in Salt Lake City presented its findings at the annual meeting of American Society of Clinical Oncology, a virtual meeting now underway.

Researchers led by Utah professor of nursing Kathi Mooney evaluated the Huntsman at Home service, a plan for patients needing continued acute level medical care after hospitalization or have emerging unstable symptoms. The service aims to keep patients connected to clinicians through virtual and telephone visits, coaching for family members and caregivers, and visits by clinicians to the home if necessary. Patients can use the Huntsman at Home service with a doctors referral and if they live within 20 miles of the Huntsman facility or need special monitoring.

Mooney and lab colleagues study physical and psycho-social factors that contribute to cancer care, including remote monitoring and care management platforms. These systems often connect clinicians to patients in their homes, with the goal of improving cancer patient outcomes and reducing morbidity.

For their paper, the Utah team assessed the Huntsman at Home service almost from its beginning in August 2018 through October 2019. The researchers sampled patients referred to the service during this time, and compared these individuals to similar patients in the Salt Lake City region, but who lived outside the Huntsman at Home service area. Their analysis looked primarily at further unplanned hospitalizations, length of stay, visits to hospital emergency departments, and costs to patients after 30 and 90 days following the start of their service.

The sample drew 169 participants in the Huntsman at Home service and 198 individuals receiving the usual care, with patients being being treated for colon, gynecologic, prostate, and lung cancers. The results show in the 30 days after enrollment Huntsman at Home participants have shorter hospital stays, by 1.2 days on average, compared to usual care recipients. In addition, Huntsman at Home participants are 56 percent less likely to have an unplanned hospitalization and 45 percent less likely to visit a hospital emergency department. And Huntsman at Home participants have lower cumulative costs after 30 and 90 days, by about 50 percent, compared to usual care recipients.

“These findings strongly support our hypothesis,” says Mooney in an institute statement, “that Huntsman at Home’s high-quality, acute-level cancer care using a hospital-at-home model improves outcomes while simultaneously improving value.” The researchers say they plan to continue evaluating the program, with Huntsman at Home expected to expand its service area to several rural counties in Utah.

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