Randomized study of early hospital discharge following autologous blood SCT: medical outcomes and hospital costs

Abstract : We report the first randomized study comparing early hospital discharge with standard hospital-based follow-up after high-dose chemotherapy (HDCT) and PBSCT. Patients aged 18-65 years, with an indication of PBSCT for non-leukemic malignant diseases were randomly assigned between two arms. Arm A consisted of early hospital discharge (HDCT during hospitalization, discharge at day 0, home stay with a caregiver, outpatient clinic follow-up). In arm B patients were followed up as inpatients. In total 131 patients were analyzed (66 in arm A and 65 in arm B). Patient characteristics and hematological reconstitution were comparable between the two groups. In arm A, 26 patients were actually discharged early. Patients in group A spent fewer days in hospital (11 vs 12 days, P=0.006). This strategy resulted in a 6% mean cost reduction per patient when compared with the conventional hospital-based group. The early discharge approach within the French health system, while safe and feasible, is highly dependent on social criteria (caregiver availability and home to hospital distance). It is almost always associated with conventional hospital readmission during the aplasia phase, and limits cost savings when considering the whole population of patients benefiting from HDCT in routine clinical practice.
Complete list of metadatas

Cited literature [23 references]  Display  Hide  Download

https://www.hal.inserm.fr/inserm-02294378
Contributor : Christine Dupuis <>
Submitted on : Monday, September 23, 2019 - 2:09:08 PM
Last modification on : Thursday, September 26, 2019 - 1:54:08 PM

File

 Restricted access
To satisfy the distribution rights of the publisher, the document is embargoed until : jamais

Please log in to resquest access to the document

Identifiers

Collections

Citation

C Faucher, A Le Corroller Soriano, B Esterni, N. Vey, A Stoppa, et al.. Randomized study of early hospital discharge following autologous blood SCT: medical outcomes and hospital costs. Bone Marrow Transplantation, Nature Publishing Group, 2012, 47 (4), pp.549-555. ⟨10.1038/bmt.2011.126⟩. ⟨inserm-02294378⟩

Share

Metrics

Record views

83