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Real-World Health Care Utilization and Costs in the Huntsman at Home Program
A recent study found that an oncology hospital at home program model may lower unplanned health care utilization and health care costs for patients with cancer (J Clin Oncol. 2021; JCO2003609. doi:10.1200/JCO.20.03609.)
Kathi Mooney, PhD, RN, FAAN, Huntsman Cancer Institute, University of Utah, and colleagues examined an oncology hospital at home program’s rate of unplanned hospitalizations, health care costs, emergency department (ED) use, length of hospital stays, and intensive care unit (ICU) admissions during the 30 days after enrollment, aiming to understand whether new models of care are beneficial, due to the high rates of morbidity and unplanned health care utilization among patients with cancer.
This prospective, nonrandomized, real-world, comparative study included 367 hospitalized patients with cancer who met clinical criteria for admission to a hospital-at-home program called Huntsman at Home. Of these patients 169 were consecutively admitted after hospital discharge to Huntsman at Home and compared with 198 patients who received usual care concurrently identified at hospital discharge.
The primary study outcomes were the number of unplanned hospitalizations and costs during the 30 days after enrollment. Secondary outcomes were length of hospital stays, ICU admissions, and ED visits during the 30 days after enrollment.
Primary outcomes favored Huntsman at Home, as the odds of unplanned hospitalizations were reduced in the Huntsman at Home group by 55% (odds ratio, 0.45, 95% CI, 0.29 to 0.70; P <.001), and health care costs were 47% lower (mean cost ratio, 0.53; 95% CI, 0.39 to 0.72; P <.001) over the 30-day period. Total hospital stay days were reduced by 1.1 days (P = .004) and ED visits were reduced by 45% (odds ratio, 0.55; 95% CI, 0.33 to 0.92; P = .022), suggesting that secondary outcomes also favored Huntsman at Home.
“This oncology hospital at home program shows initial promise as a model for oncology care that may lower unplanned health care utilization and health care costs” concluded Dr Mooney and colleagues.—Marta Rybczynski
