{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:11:12Z","timestamp":1789603872293,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:00:00Z","timestamp":1638403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Home\u2010based treatment of febrile neutropenia (FN) in children with cancer with oral or intravenous antibiotics is safe and effective. There are limited data on the economic impact of this model of care. We evaluated the cost\u2010effectiveness of implementing an FN programme, incorporating home\u2010based intravenous antibiotics for carefully selected patients, in a tertiary paediatric hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A decision analytic model was constructed to compare costs and outcomes of the home\u2010based FN programme, with usual in\u2010hospital treatment with intravenous antibiotics. The programme included a clinical decision rule to stratify patients by risk for severe infection and home\u2010based eligibility criteria using disease, chemotherapy and patient\u2010level factors. Health outcomes (quality of life) and probabilities of FN risk classification and home\u2010based eligibility were based on prospectively collected data between 2017 and 2019. Patient\u2010level costs were extracted from hospital administrative records. Cost\u2010effectiveness was expressed as the incremental cost per quality\u2010adjusted life year (QALY).<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>The mean health care cost of home\u2010based FN treatment in low\u2010risk patients was Australian dollars (A$) 7765 per patient compared to A$20,396 for in\u2010hospital treatment (mean difference A$12,632 [95% CI: 12,496\u201312,767]). Overall, the home\u2010based FN programme was the dominant strategy, being more effective (0.0011 QALY [95% CI: 0.0011\u20130.0012]) and less costly. Results of the model were most sensitive to proportion of children eligible for home\u2010based care programme.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared to in\u2010hospital FN care, the home\u2010based FN programme is cost\u2010effective, with savings arising from cheaper cost of caring for children at home. These savings could increase as more patients eligible for home\u2010based care are included in the programme.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.29469","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T10:23:21Z","timestamp":1638440601000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Cost\u2010effectiveness of home\u2010based care of febrile neutropenia in children with cancer"],"prefix":"10.1002","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3009-8056","authenticated-orcid":false,"given":"Michelle","family":"Tew","sequence":"first","affiliation":[{"name":"Centre for Health Policy, Melbourne School of Population and Global Health University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Health Services Research Peter MacCallum Cancer Centre  Melbourne Victoria Australia"},{"name":"National Centre for Infections in Cancer Peter 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