Impact of shifting from office- to hospital-based treatment facilities on the administration of intraperitoneal chemotherapy for XXXX .

@entity5 @entity1 @entity43
INTRODUCTION: @entity5 chemotherapy in the United States has been delivered mostly in an office-based setting since the late 1980s. However, in the past 5 years, more @entity1 have been treated in hospitals as a result of reimbursement changes. Intraperitoneal (IP) chemotherapy for @entity43 has been similarly affected. This report examines changes in care of @entity1 treated with IP chemotherapy in an office- versus hospital-based setting. METHODS: Over 10 years, 140 @entity1 with @entity43 were identified as candidates for IP chemotherapy. Of these @entity1 , 92 were treated in an oncology-dedicated infusion center in the office of a physicians' group; 48 were treated in a local hospital. Location was determined based on insurance coverage and reimbursement. Data collected included demographics, number of treatment cycles completed, length of each treatment, and adverse events. RESULTS: The age and ethnicity of @entity1 treated in the office versus hospital were similar. All six doses of intravenous IP chemotherapy were completed by 73 (79%) of 92 @entity1 treated in the office versus 23 (48%) of 48 @entity1 treated in the hospital (P < .001). The time of each infusion was longer in the hospital-versus office-based setting (P < .001). There were more adverse events associated with treatment in the hospital. CONCLUSION: IP chemotherapy is associated with worse outcomes in the hospital- compared with office-based setting. The reason seems to involve a relative lack of resources directed specifically to chemotherapy administration. If current reimbursement trends continue, this could result in decreased survival for @entity1 with @entity43 .
