Safety and cost effectiveness of early hospital discharge of lower risk children with cancer admitted for fever and neutropenia

Cancer ◽  
1994 ◽  
Vol 74 (1) ◽  
pp. 189-196 ◽  
Author(s):  
Robert O. Bash ◽  
Julie A. Katz ◽  
Jayne V. Cash ◽  
George R. Buchanan
1993 ◽  
Vol 32 (8) ◽  
pp. 463-466 ◽  
Author(s):  
Deborah Coody ◽  
Robert J. Yetman ◽  
Diane Montgomery ◽  
Jan van Eys

Cancer ◽  
2001 ◽  
Vol 91 (8) ◽  
pp. 1563-1567 ◽  
Author(s):  
Hugo Paganini ◽  
Teresa Rodriguez-Brieshcke ◽  
Pedro Zubizarreta ◽  
Antonio Latella ◽  
Ver�nica Firpo ◽  
...  

Author(s):  
Christina Greenaway ◽  
Iuliia Makarenko ◽  
Claire Abou Chakra ◽  
Balqis Alabdulkarim ◽  
Robin Christensen ◽  
...  

Chronic hepatitis C (HCV) is a public health priority in the European Union/European Economic Area (EU/EEA) and is a leading cause of chronic liver disease and liver cancer. Migrants account for a disproportionate number of HCV cases in the EU/EEA (mean 14% of cases and >50% of cases in some countries). We conducted two systematic reviews (SR) to estimate the effectiveness and cost-effectiveness of HCV screening for migrants living in the EU/EEA. We found that screening tests for HCV are highly sensitive and specific. Clinical trials report direct acting antiviral (DAA) therapies are well-tolerated in a wide range of populations and cure almost all cases (>95%) and lead to an 85% lower risk of developing hepatocellular carcinoma and an 80% lower risk of all-cause mortality. At 2015 costs, DAA based regimens were only moderately cost-effective and as a result less than 30% of people with HCV had been screened and less 5% of all HCV cases had been treated in the EU/EEA in 2015. Migrants face additional barriers in linkage to care and treatment due to several patient, practitioner, and health system barriers. Although decreasing HCV costs have made treatment more accessible in the EU/EEA, HCV elimination will only be possible in the region if health systems include and treat migrants for HCV.


Author(s):  
Michelle Tew ◽  
Richard De Abreu Lourenco ◽  
Joshua Gordon ◽  
Karin Thursky ◽  
Monica Slavin ◽  
...  

INTRODUCTION Home-based treatment of low-risk febrile neutropenia (FN) in children with cancer with oral or intravenous antibiotics is safe and effective. There are limited data on the economic impact of this model of care. We evaluated the cost-effectiveness of implementing a low-risk FN program, incorporating home-based intravenous antibiotics, in a tertiary pediatric hospital. METHODS A decision analytic model was constructed to compare costs and outcomes of the low-risk FN program, with usual in-hospital treatment with intravenous antibiotics. The program included a clinical decision rule to identify patients at low-risk for severe infection and home-based eligibility criteria using disease, chemotherapy and patient-level factors. Health outcomes (quality-of-life) and probabilities of FN risk classification and home-based eligibility were based on prospectively collected data. Patient-level costs were extracted from hospital records. Cost-effectiveness was expressed as the incremental cost per quality-adjusted life year (QALY). FINDINGS The mean healthcare cost of home-based FN treatment in low-risk patients was A$7,765 per patient compared to A$20,396 for in-hospital treatment (mean difference A$12,632 (95% CI,12,496-12,767)). Overall, the low-risk FN program was the dominant strategy, being more effective (0.0011 QALY (95% CI,0.0011-0.0012)) and less costly. Results of the model were most sensitive to proportion of children eligible for home-based care program. CONCLUSION Compared to in-hospital FN care, the low-risk FN program is cost-effective, with savings arising from cheaper cost of caring for children at home. These savings could increase as more patients eligible for home-based care are included in the program.


2021 ◽  
Author(s):  
Michelle Tew ◽  
Richard De Abreu Lourenco ◽  
Joshua Robert Gordon ◽  
Karin A. Thursky ◽  
Monica A. Slavin ◽  
...  

2019 ◽  
Vol 220 (3) ◽  
pp. 253.e1-253.e7 ◽  
Author(s):  
Nigel Madden ◽  
Melissa K. Frey ◽  
LiJin Joo ◽  
Jessica Lee ◽  
Kelsey Musselman ◽  
...  

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