Acute oncology hospital care at home for post-chemotherapy monitoring.

The HaH cohort demonstrated non-inferiority to the control cohort for 30-day emergency room visits.

• 30-day ER visits had an odds ratio of 1.07 (95% CI = 0.91, 1.26), indicating non-inferiority
• 30-day hospital admissions as defined by CMS were 0% in the HaH cohort vs. 1.6% in the control cohort
• The study used a quasi-experimental design with a retrospective chart review
• Control cohort consisted of patients living in zip codes excluded from HaH's catchment area

The HaH program achieved a high rate of successful admissions and saved a substantial number of inpatient bed-days.

• Successful HaH admissions occurred for 92% (95% CI = 80.6%, 100%) of care episodes
• Mean HaH length of stay was 8.7 days (SD = 3.9)
• A total of 208.8 inpatient bed-days were saved across HaH episodes
• 24 HaH episodes of care were identified from September 2020 to May 2023

Total length of stay was numerically shorter in the HaH cohort compared to the control cohort, though not statistically significant.

• The HaH cohort had a mean total LOS (hospital plus HaH) of 16 days (SD = 4.5) vs. 19.2 days (SD = 11.9) in the control cohort
• The difference in total LOS was not statistically significant (p = 0.198)
• The control cohort included 62 episodes of care compared to 24 HaH episodes

Patients enrolled in HaH differed demographically from the control cohort, being younger and more racially diverse.

• HaH patients were described as younger and more racially diverse than the control cohort
• These demographic differences likely reflect geographic selection bias due to HaH enrollment being limited to specific catchment area zip codes
• The study period spanned September 2020 to May 2023

The study population consisted of patients with multiple myeloma receiving DCEP±V chemotherapy who transitioned from inpatient to home-based hospital care.

• Patients received dexamethasone, cyclophosphamide, etoposide, and cisplatin with or without bortezomib (DCEP±V)
• Chemotherapy was initiated in the hospital, with continuation of hospitalization occurring at home
• Primary endpoints were 30-day hospital readmissions and 30-day ER visits
• The study hypothesis was that the HaH cohort would be non-inferior to the control cohort