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2017, Number 3

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Rev Hematol Mex 2017; 18 (3)

Ambulatory treatment of febrile neutropenia, cost and effectiveness assessment

Cantú-Rodríguez OG, González-Martínez A, Garza-Acosta AC, Gutiérrez-Aguirre CH, Gómez-Almaguer D

Language: Spanish
References: 21
Page: 105-113
PDF size: 279.96 Kb.


ABSTRACT

Background: Febrile neutropenia is a common complication of chemotherapy that significantly impacts on treatment response and requires an expensive management. Outpatient treatment is an alternative for low risk patients, supported by a clinic that facilitates early access to laboratory and medication. An additional benefit is a greater capacity of patient care, optimizing economic resources by cost reduction. There are currently comparative studies with hospital admission and outpatient management, as well as cost analysis; nevertheless, there are no reports in Mexico.
Objetive: To assess the results of treatment of febrile neutropenia in patients with hematological diseases in the intrahospitalary and ambulatory setting, besides the safety, efficacy and convenience of the latest and costs of care of these patients in our center.
Material and Method: An observational, descriptive, prospective study was performed from August 2014 to June 2015, involving patients with hematological disease and febrile neutropenia. Patients at low risk according to the MASCC scale received outpatient management at hematology clinic.
Results: There were included 39 patients, from which 62% received hospital admission, and 38% outpatient management. We found no statistically significant differences between the two groups regarding treatment days, neutropenia recovery time, or changes in antibiotic treatment. The average outpatient cost was 10,796.22 Mexican pesos and that of the hospital management was 41,160.34 Mexican pesos (p = 0.001). In the outpatient group, 4 patients required hospitalization on subsequent days. There were 5 deaths, 3 in the inpatient treatment group and 2 in the outpatient group subsequently hospitalized (p = 0.649).
Conclusions: Outpatient management of febrile neutropenia in low-risk patients may be successful and significantly less expensive than hospital management.


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