Day hospital as an alternative to inpatient care for cancer patients: A random assignment trial

Vincent Mor, Martha Z. Stalker, Richard Gralla, Howard I. Scher, Claudia Cimma, Donna Park, Anne Marie Flaherty, Margaret Kiss, Paul Nelson, Linda Laliberte, Rachel Schwartz, Paul A. Marks, Herbert F. Oettgen

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

A stratified, random-assignment trial of 442 cancer patients was conducted to evaluate medical, psychosocial, and financial outcomes of day hospital treatment as an alternative to inpatient care for certain cancer patients. Eligible patients required: a 4- to 8-hour treatment plan, including chemotherapy and other long-term intravenous (i.v.) treatment; a stable cardiovascular status; mental competence; no skilled overnight nursing; and a helper to assist with home care. Patients were ineligible if standard outpatient treatment was possible. No statistically significant (p < 0.05) differences were found between the Adult Day Hospital (ADH) and Inpatient care in medical or psychosocial outcomes over the 60-day study period. The major difference was in medical costs-approximately one-third lower for ADH patients (p < 0.001) than for the Inpatient group. The study demonstrates that day hospital care of medical oncology patients is clinically equivalent to Inpatient care, causes no negative psychosocial effects, and costs less than Inpatient care. Findings support the trend toward dehospitalization of medical treatment.

Original languageEnglish (US)
Pages (from-to)771-785
Number of pages15
JournalJournal of Clinical Epidemiology
Volume41
Issue number8
DOIs
StatePublished - 1988

Keywords

  • Alternative to hospital
  • Cost
  • Cost-effectiveness
  • Quality of life
  • Randomized design

ASJC Scopus subject areas

  • Epidemiology

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