Feasibility of a home care program in a pediatric hematology and oncology department. Results of the first year of activity at a single Institution.
OBJECTIVE
Giannina Gaslini Children's Hospital (GGCH) is a tertiary care hospital with an average of 100 new cancer diagnoses made each year. In April 2000, following preliminary analysis of the potential benefits, and the results of a questionnaire filled in by the parents attending the out-patient clinic, a Home Care (HC) program was started.


METHODS
Children in stable, non-critical, clinical conditions requiring i.v. therapy, parenteral nutrition, transfusional support, blood examinations, and central venous catheter use training management, as well as terminally ill children needing palliative and support therapy were considered eligible for the program.


RESULTS
After one year of activity, 45 children, aged 1 month-19 years (median 3 years), requiring i.v. therapy and blood tests in 32 cases, central venous catheter use training in 5, and palliative care in 8, were treated at home. The median duration of assistance for each child was 19 days (range 1-172). An average of 4 patients per week were assisted for a total of 1,364 days. A total of 881 accesses at home replaced 551 and 330 out-patient and in-patient days of hospitalization, respectively. The average cost per patient given home care (2,936 E, range 150-20,700) resulted to be significantly lower than the average cost per patient hospitalized to undergo the same procedures (9,785E, range 350-96,750).


CONCLUSIONS
The opportunity to reduce the frequency and duration of hospitalization represents an incalculable advantage for these children and their families. This report shows that home care is a feasible kind of assistance for children suffering from cancer, and reduces costs as well.
Miano
Maurizio
M
Dept. of Paediatric Haematology and Oncology, Giannina Gaslini Children's Hospital, largo G. Gaslini 5, 16148 Genoa, Italy.
Manfredini
Luca
L
Garaventa
Alberto
A
Fieramosca
Sara
S
Tanasini
Rita
R
Leimer
Monica
M
Trucco
Daniela
D
Rossi
Rossella
R
Haupt
Riccardo
R
Dini
Giorgio
G
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D018575:Home Care Services, Hospital-Based / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D006776:Hospitals, Pediatric / Q000458:organization & administration; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D016522:Oncology Service, Hospital / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D011795:Surveys and Questionnaires