Hospital-at-home for oncology: treating low-risk febrile neutropenia and dehydration at home
Many hospital stays for cancer patients, such as for fever after chemotherapy in low-risk cases, could be delivered at home with daily nurse visits and remote monitoring, which patients prefer and which is cheaper.
Hospital-at-home programmes deliver acute-level care (IV antibiotics, fluids, monitoring, daily nurse and physician oversight) in the patient's home and have shown equivalent or better outcomes, fewer complications, and lower costs in general medicine. Oncology-specific programmes (such as Huntsman at Home) report reduced admissions and emergency visits. Expanding the model to defined oncology conditions, with payer recognition, would reduce hospitalisation, which is particularly harmful for older patients.
- Older and multimorbid patients are excluded and undertreated · Most people with cancer are over 65 but most trial patients are younger and fitter. We guess how to treat the majority.
- Fragmented care and guideline gaps · Patients fall between specialists, wait for referrals and often do not get the treatment guidelines say they should.
- Toxicity and quality of life are undervalued · Trials measure how long people live, not how they live. Side-effects are under-reported and under-treated.
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not linked directly; found by shared links- IdeaA standard handoff with medication reconciliation at every cancer care transition
Shares Older and multimorbid patients are excluded and undertreated, Fragmented care and guideline gaps, Toxicity and quality of life are undervalued.
- IdeaFormal shared-care agreements between oncology and family doctors, with same-day e-consult
Shares Older and multimorbid patients are excluded and undertreated, Fragmented care and guideline gaps.
- IdeaOncology hospital-at-home with remote monitoring for toxicity
Shares Fragmented care and guideline gaps, Toxicity and quality of life are undervalued.
- IdeaHome administration of selected chemotherapy and immunotherapy for older and frail patients
Shares Older and multimorbid patients are excluded and undertreated, Fragmented care and guideline gaps.
- IdeaA defined pathway for patients with both dementia and cancer
Shares Older and multimorbid patients are excluded and undertreated, Fragmented care and guideline gaps.
- IdeaWeekly electronic symptom reporting as a standard of care during systemic therapy
Shares Fragmented care and guideline gaps, Toxicity and quality of life are undervalued.
- IdeaReport time toxicity, the days spent in healthcare, as a standard outcome for older patients
Shares Older and multimorbid patients are excluded and undertreated, Toxicity and quality of life are undervalued.
- InstitutionWilmot Cancer Institute, University of Rochester
Shares Older and multimorbid patients are excluded and undertreated, Toxicity and quality of life are undervalued.