Inpatient versus Outpatient Chemotherapy—Benefits, Risks, and Costs

In conclusion, the future will need oncology physicians to lead the healthcare team for the benefit of their patients, according to Dean Gesme, MD, FACP, FACPE, Past Chair, ASCO Clinical Practice Committee, and payers should be included in the equation. Dr. Gesme summarized, “Together we must work to maximize value offered within our healthcare system.” he summarized.¹ 

REFERENCES

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2. Dollinger M. Guidelines for hospitalization for chemotherapy. Oncologist. 1996;1(1&2):107-111.

3. Jacobson M, Earle CC, Price M, Newhouse JP. How Medicare’s payment cuts for cancer chemotherapy drugs changed patterns of treatment. Health Aff (Millwood). 2010;29(7):1391-1399.

4. Helwick C. A conversation with Joseph S. Bailes, MD, ASCO Immediate Past Chair of Government Relations. 2010;1(4):29-30. Accessed June 4, 2012.  http://issuu.com/ascopost/docs/tap-vol-1-issue-4/29?zoomed=&zoomPercent=&zoomX=&zoomY=¬eText=¬eX=¬eY=&viewMode=magazine

5. Friedman JY, Curtis LH, Hammill BG, et al. The Medicare Modernization Act and reimbursement for outpatient chemotherapy: do patients perceive changes in access to care. Cancer. 2007;110(10):2304-2312.  

6. Shea AM, Curtis LH, Hammill BG, et al. Association between the Medicare Modernization Act of 2003 and patient wait times and travel distance for chemotherapy. JAMA. 2008;300(2):189-196.   

7. Habib JL. Cancer care is jeopardized by Medicare reimbursement. Drug Benefit Trends. 2010;22:2.   

8. Vera-Llonch M, Weycker D, Glass A, et al. Healthcare costs in patients with metastatic lung cancer receiving chemotherapy. BMC Health Serv Res. 2011;11:305.

9. Kirschenbaum B. Quirks in the reimbursement: it’s hard to get paid if you don’t know the rules. Oncology Issues. 2010:38-46

10. Roemer J. An end to outpatient chemotherapy. Medicare takes aim at reimbursement.  J Natl Cancer Inst. 1999;91(17):1444-1445.

11. Robinson WR, Beyer J. Impact of shifting from office- to hospital-based treatment facilities on the administration of intraperitoneal chemotherapy for ovarian cancer. J Oncol Pract. 2010;6(5):232-235.  

12. Jacobson JO, Polovich M, McNiff KK, et al. American Society of Clinical Oncology/Oncology Nursing Society chemotherapy administration safety standards. Oncol Nurs Forum. 2009;36(6):651-658.  

13. American Society of Clinical Oncology. Criteria for facilities and personnel for the administration of parenteral systemic antineoplastic therapy. Adopted on March 3, 2004 by the American Society of Clinical Oncology. J Clin Oncol. 2004;22(22):4613-4615.

14. American Society of Health-System Pharmacists. ASHP guidelines on preventing medication errors with antineoplastic agents. Am J Health-Syst Pharm. 2002;59:1648-1668.

15. Jacobson JO, Polovich M, Gilmore TR, et al. Revisions to the 2009 American Society of Clinical Oncology/Oncology Nursing Society chemotherapy administration safety standards: expanding the scope to include inpatient settings. J Oncol Pract. 2012;8(1):2-6.

16. American Society of Clinical Oncology/Oncology Nursing Society. Chemotherapy Administration Safety Standards [PUBLIC COMMENT DRAFT]: Including proposed oral chemotherapy additions and revisions. Version dated 2-28-2012. http://ons.org/media/ons/docs/education/2012_standards_public_comment.pdf. Accessed June 4, 2012; Adapted from: Dollinger M. Guidelines for hospitalization for chemotherapy. Oncologist. 1996;1(1&2):107‑111.²