title: Reduced charges and costs associated with outpatient autologous stem cell transplantation.
abstract: High-dose chemotherapy and stem cell rescue is increasingly being delivered in the outpatient setting. Such intensive outpatient management programs have reduced the total hospital length of stay without compromising clinical outcomes. However, a detailed financial analysis of outpatient programs has not been performed. These data are the results of a prospective study of 94 patients receiving high-dose chemotherapy and autologous peripheral blood stem cell transplant in one of three settings: traditional inpatient, partial outpatient, total outpatient. Patients were allowed to choose their own treatment setting based upon the availability of a caregiver and personal preference. Total hospital length of stay and the actual cost and charges for each patient were monitored prospectively. The patients in the three groups were well balanced with regard to age and functional status prior to high-dose chemotherapy. The average length of stay was reduced from 17.3 to 8.2 to 2.7 days in the three different treatment settings (P < 0.01). Mean procedure costs were reduced from $39.7 thousand (US dollars) to $36.2 thousand to $29.4 thousand in the three treatment settings (P < 0.029). No differences in toxicity or overall response to therapy was noted. High-dose chemotherapy and stem cell rescue can be safely administered in the outpatient setting and results in significant cost savings.
authors.affiliation: Ida M and Cecil H Green Cancer Center and the Division of Hematology and Oncology, Scripps Clinic and Research Foundation, La Jolla, CA, USA.
authors.forename: B R
authors.initials: BR
authors.lastname: Meisenberg
authors.forename: K
authors.initials: K
authors.lastname: Ferran
authors.forename: K
authors.initials: K
authors.lastname: Hollenbach
authors.forename: T
authors.initials: T
authors.lastname: Brehm
authors.forename: J
authors.initials: J
authors.lastname: Jollon
authors.forename: L D
authors.initials: LD
authors.lastname: Piro
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics*; D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003365:Costs and Cost Analysis; D005249:Fees and Charges; D018380:Hematopoietic Stem Cell Transplantation / Q000191:economics* / Q000379:methods*; D017722:Hospital Charges; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000628:therapy; D011446:Prospective Studies; D012449:Safety; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents