Differences in health care use and costs among patients with cancer receiving intravenous chemotherapy in physician offices versus in hospital outpatient settings

Abstract

Purpose The current shift in site of care from community oncology practices to the hospital outpatient department to deliver oncology services may have significant implications for the economic and clinical outcomes of cancer care. Therefore, this study compares health care use and costs among patients with cancer receiving intravenous (IV) chemotherapy in physician offices (PO) versus in hospital outpatient settings (HOP). Methods This retrospective study, which was based on medical and pharmacy claims data, included patients (age, 18 to 64 years) initiating IV chemotherapy/biologic treatment between January 1, 2006, and August 31, 2012,whowere diagnosed with early or metastatic breast cancer, metastatic lung cancer, metastatic colorectal cancer, or non-Hodgkin lymphoma or chronic lymphocytic leukemia. Patients were assigned toPOorHOPgroups on the basis of where they received >95% of their IV cancer therapy. Results The study sample included 18,740 patients (12,899 PO; 5,841HOP)whohad ameanage of 51.6 years and a Deyo-Charlson Comorbidity Index score of 5.37. Overall office visits (21.8 ±13.8 PO v 21.2±12.9, P