title: Cost effectiveness of integrated medicine in patients with cancer receiving anticancer chemotherapy.
abstract: OBJECTIVE
  Ambulatory chemotherapy is patient friendly but may result in toxicity-induced unscheduled hospitalizations (TIUHs). This emerging issue may increase health care costs. We studied the cost effectiveness of a hospital-home monitoring program based on systematic iterative telephone calls after chemotherapy.
  
  
  METHODS
  We retrospectively evaluated the rates of chemotherapy-induced unscheduled hospitalizations in patients who were treated in August 2008. Patients were contacted by telephone 1 day before chemotherapy and on the second and eighth days after undergoing chemotherapy. Costs associated with TIUHs were calculated and compared with those of a cohort concomitantly treated using the standard follow-up procedure.
  
  
  RESULTS
  A total of 259 patients entered the hospital-home monitoring program. They were compared with 86 patients who had similar characteristics but underwent the standard treatment and follow-up procedure. Inclusion in the hospital-home monitoring program resulted in patients experiencing TIUHs approximately half as frequently as patients in the other group (2.4% v 4.9%; P < .01). Patients in the program experienced TIUHs for a median length of stay of 4 days, representing a nonsignificant reduction in duration of hospitalization (P not significant). Consequently, through a two-fold reduction in TIUH annual incidence, this program represents a reduction in unscheduled hospitalizations per year of 383 days, decreasing hospital costs by €201.468 ($292,468) per year.
  
  
  CONCLUSIONS
  The hospital-home monitoring program is a cost-effective strategy for offering ambulatory chemotherapy treatment to patients with cancer. This program has become our standard procedure for ambulatory chemotherapy in patients with cancer.
authors.affiliation: Cochin Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France. romain.coriat@cch.aphp.fr
authors.forename: Romain
authors.initials: R
authors.lastname: Coriat
authors.forename: Pascaline
authors.initials: P
authors.lastname: Boudou-Rouquette
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Durand
authors.forename: Priscille
authors.initials: P
authors.lastname: Forgeot d'Arc
authors.forename: Idalie
authors.initials: I
authors.lastname: Martin
authors.forename: Olivier
authors.initials: O
authors.lastname: Mir
authors.forename: Stanislas
authors.initials: S
authors.lastname: Ropert
authors.forename: Jérôme
authors.initials: J
authors.lastname: Alexandre
authors.forename: François
authors.initials: F
authors.lastname: Goldwasser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006699:Home Care Services; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000191:economics*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents