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At least 19 recordsLinked to original sources
PubMed1995

A managed care model for home infusion therapy.

Home infusion therapy began in response to the medical needs of the patients. In the traditional model, products and services were delivered in the home on a physician's prescription. Limitations related to medical quality management and cost were recognized in this model. Because of these limitations, the changes that continue to occur in health care delivery and the increase in number and acuity of patients requiring non-hospital services, a managed care model was conceived and implemented at the University of Minnesota Medical School and Hospital. This model emphasizes physician-based case management, total quality management, a point of contact medical information system, outcomes assessment and management, and research and education activities designed to evaluate and improve home infusion therapies. The model was implemented through a public-private partnership. This application of managed care to home infusion therapies is described in this communication.

Clinical Protocols↗
PubMed1992

Current status of home infusion therapy.

The growth of home infusion therapy has been influenced by external forces that have changed the access to and use of health care. As home infusion therapy expands into other alternate care settings, clinicians, regardless of discipline, must be cognizant of how daily clinical practice is affected by regulations, changes in legislation, and consumerism.

Accreditation↗
PubMed1995

Home health care costs: intravenous immunoglobulin home infusion therapy.

BACKGROUND: Home health care has been touted as a cost-saving option for many immune disorders, especially those requiring intravenous immunoglobulin (IVIG). OBJECTIVE: To determine the costs for home infusions of IVIG, a comparative study of Home Health Agency prices was undertaken. METHOD: A survey of 25 Home Health Agencies that provide IVIG therapy in northern and central New Jersey was conducted by telephone and office interviews. RESULTS: Thirteen companies provided price quotations for services and IVIG. The highest-priced companies charge approximately four times more for IVIG infusions than the lowest-priced companies, and many agencies offer the therapy at moderate costs. CONCLUSION: IVIG can be obtained and administered in the home in more cost-effective ways if comparative pricing is done.

Costs and Cost Analysis↗
PubMed1996

Home infusion therapy.

OBJECTIVES: To examine issues related to the planning of an effective home infusion therapy program and to provide an overview of specific home infusion therapies for patients with cancer. DATA SOURCES: Published articles, research studies, guidelines, and standards pertaining to infusion therapies. CONCLUSIONS: Advances in technology have expanded and increased the scope and success of home infusion therapy. Antimicrobial therapy, chemotherapy, pain management, total parenteral nutrition, and blood transfusion therapy are commonly administered to cancer patients at home. IMPLICATIONS FOR NURSING PRACTICE: A competent and experienced nursing staff is the cornerstone of a successful home infusion program. Safe provision of infusion therapy and care can be assured through selection of appropriate patients, effective patient education, well-defined agency policies, and effective coordination of home care services.

Antineoplastic Agents↗
PubMed1995

Home infusion therapy: meeting a need.

A home infusion program for a midsize hospital was developed to meet the needs of patients discharged on specific infusion therapies. The program's history, development, credentialing, referral and QA/QI process are described. The infusion nurse provides in-hospital teaching, discharge coordination, and follow-up at home while working with physicians, social workers, hospital nurses and home-infusion-therapy providers.

Health Services Needs and Demand↗
PubMed1994

Physicians, pharmacists, and home infusion antibiotic therapy.

Home infusion antibiotic therapy has been proven effective, safe, and economical for a variety of infectious diseases. Programs for home infusion have been established in hospitals, home care companies, and physician offices. These programs utilize the combined efforts of physicians, pharmacists, and nurses and rely heavily on the active participation of the patient to provide quality care for a fraction of the cost of hospital-based infusion. Additionally, given a choice, patients prefer to receive intravenous antibiotic therapy at home. Current reimbursement policies, however, acknowledge neither the economic benefit to be derived from home therapy nor patient preference for this mode of intravenous antibiotic therapy.

Anti-Bacterial Agents↗
PubMed1988

Impact of home infusion therapy on the Colorado Medicaid program budget.

The impact of home infusion therapies on the pharmaceutical services drug budget of the Colorado Medicaid program was evaluated retrospectively. Pharmacy billing claims and prior authorization forms for home infusion therapies submitted to the Colorado Department of Social Services during a 26-month period were reviewed to determine the costs of the drug or hydration solutions and ancillary products necessary for the preparation and administration of the solutions. A dispensing fee of +3.40 per dose was figured into calculations of total costs of home infusion therapies, and an estimated cost of +100-+150 per day for follow-up care was added. Equivalent costs of hospitalization were calculated using an average per diem charge of +315. A total of 61 patients received 1361 days of home infusion therapy during the study period. The majority of patients received home antimicrobial therapy; 752 days of hospitalization theoretically were avoided because of home administration of antimicrobial agents, which translates into a cost savings of +76,716-+114,316. Patients also received home parenteral nutrition therapy, analgesic therapy, and rehydration therapy that yielded cost savings of +48,374-+78,824 but in some cases resulted in higher costs than hospitalization would have. Home infusion therapies increased pharmaceutical services costs by +99,475, representing an important shift of costs from the hospital services budget to the pharmaceutical services budget. Home infusion therapies generally incur lower costs than would be incurred during an equivalent hospital stay. The Colorado Medicaid budget should be adjusted to compensate for the shift of costs from hospital to pharmaceutical services.

Anti-Infective Agents↗
PubMedDate not supplied

The characteristics and clinical practices of nurses who perform home infusion therapies.

In the current ever-changing healthcare environment, home infusion therapy has become commonplace. As home infusion becomes more advanced and the homecare patient is sicker, a more highly skilled nurse is needed to provide these complex therapies. The question is: Are nurses in home infusion therapy clinically and educationally prepared to meet the challenges and needs in this setting? A partial replication of MacPherson's 1999 study was conducted to determine the clinical and educational characteristics of the home infusion therapy nurse in a rural setting.

Adult↗
PubMed2003

Collaboration of nursing and pharmacy in home infusion therapy.

This article explores the role of the home care nurse and the home infusion pharmacist in providing home infusion therapy. Ways to support collaboration, strategies to improve communication, and factors to consider when providing home infusion therapy are discussed.

Communication↗
PubMed1992

[Benefits and problems of home infusion therapy].

A survey was performed to clarify the benefits and problems of home infusion therapy because 8 years had passed since this type of treatment was officially approved in Japan. Questionnaires were sent to hemophiliacs and the physicians in charge of hemophiliacs in the Kyushu district. The main results obtained from analysis of responses concerning 197 patients were as follows. 1) Out of 197, 140 patients were on home therapy programs. 2) The number of bleeding episodes was increased in 6.8%, decreased in 51.1% and unchanged in 42.1% of patients after the start of home infusion therapy programs. 3) The severity of bleeding symptoms was reduced in 92.9% of patients after the start of these programs. 4) After the start of home infusion therapy programs, the amount of blood products administered increased in 24.4%, decreased in 20.6% and was unchanged in 55.0%. 5) Complications such as abdominal pain, headache, ulticaria, itching, shivering, fever and discomfort were reported from 19 hemophiliacs. Only one of them visited the hospital due to severe abdominal pain which appeared immediately after home infusion of blood product. 6) It was indicated that better education or re-education of home infusion therapy is necessary for hemophiliacs and/or their families who are on home infusion therapy programs, because half of them had not received proper education concerning home infusion.

Blood Substitutes↗
PubMed1999

Prospective evaluation of risk factors for bloodstream infection in patients receiving home infusion therapy.

BACKGROUND: Intravenous therapy in the outpatient and home settings is commonplace for many diseases and nutritional disorders. Few data are available on the rate of and risk factors for bloodstream infection among patients receiving such therapy. OBJECTIVE: To determine rates of and risk factors for bloodstream infection among patients receiving home infusion therapy. DESIGN: Prospective, observational cohort study. SETTING: Cleveland, Ohio, and Toronto, Ontario, Canada. PATIENTS: Patients receiving home infusion therapy through a central or midline catheter. MEASUREMENTS: Primary laboratory-confirmed bloodstream infection. RESULTS: Among 827 patients (988 catheters), the most common diagnoses were infections other than HIV (67%), cancer (24%), nutritional and digestive disease (17%), heart disease (14%), receipt of bone marrow or solid organ transplants (11%), and HIV infection (7%). Sixty-nine bloodstream infections occurred during 69,532 catheter-days (0.99 infections per 1000 days). In a Cox regression model with time-dependent covariates, independent risk factors for bloodstream infection were recent receipt of a bone marrow transplant (hazard ratio, 5.8 [95% CI, 3.0 to 11.3]), receipt of total parenteral nutrition (hazard ratio, 4.1 [CI, 2.3 to 7.2]), receipt of therapy outside the home (for example, in an outpatient clinic or physician's office) (hazard ratio, 3.6 [CI, 2.2 to 5.9]), use of a multilumen catheter (hazard ratio, 2.8 [CI, 1.7 to 4.7]), and previous bloodstream infection (hazard ratio, 2.5 [CI, 1.5 to 4.2]). Rates of bloodstream infection per 1000 catheter-days varied from 0.16 for patients with none of these 5 risk factors to 6.77 for patients with 3 or more risk factors. Centrally inserted venous catheters were associated with a higher risk than implanted ports were, but the difference was not statistically significant. CONCLUSION: Bloodstream infections seem to be infrequent among outpatients receiving infusions through central and midline catheters. However, the rate of infection increases with bone marrow transplantation, parenteral nutrition, infusion therapy in a hospital clinic or physician's office, and use of multilumen catheters. Compared with implanted ports or peripherally inserted catheters, centrally inserted venous catheters may confer greater risk for bloodstream infection.

Catheterization↗
PubMed1992

Hospital selection of home infusion therapy companies as preferred providers.

The process by which a hospital selected home infusion therapy providers is described. Administrators at a 379-bed teaching hospital decided to attempt to reduce the high mean length of stay by expanding the use of home infusion therapy. Direct diversification into this field by the hospital was not feasible, so it was decided to establish contractual agreements with providers. A task force was appointed to evaluate and choose vendors in the area and to increase the number of patient referrals. The task force examined reports on past experience with providers, price lists, the range and level of services offered, and the amount of free care given and visited the companies' facilities. The group designated three providers as preferred and two as unacceptable. The number of patients referred increased from 21 during the 12 months before the task force was convened to 46 in the first 9 months afterward, for a saving of 2198 patients days. After one year the task force met again to consider company requests for evaluation or reevaluation, establish a plan for publicizing the benefits of home infusion therapy, and replace the site visits with a requirement for accreditation by the Joint Commission. After two years, the task force developed provider-evaluation criteria to streamline the process and reflect the experience gained. The responsibility for reviewing providers was transferred to the P&T committee. When a direct venture into home infusion therapy is not fiscally desirable, contracting for services can still offer the advantages of reduced length of stay and decreased drug expenses.

Anti-Bacterial Agents↗
PubMed2000

[Home infusion therapy system from a resident's point of view].

We started a new home infusion therapy system in July 1999. The home infusion therapy system is made up of doctors, nursing stations, and pharmacies in the community. We coordinate these parties before patient discharge from our hospital and support them when the patient needs hospitalization (for example, he or she develops pneumonia). This report discusses past experiences and future issue.

Home Care Services, Hospital-Based↗
PubMedDate not supplied

A model for home infusion therapy initiation and maintenance.

Many factors impact the success of home infusion therapy. A model has been designed to incorporate all of the factors that need to be considered when setting up a home infusion program. The primary factors included in the model are patient, nursing, medical, caregiver, equipment, environment, medication, and legal issues. Each of the factors are subdivided into relevant points to be included in the patient's discharge management plan. Using the model will help nurses make a comprehensive patient assessment, plan patient and caregiver education, and assist patients in completing their course of infusion therapy.

Body Image↗
PubMed1998

Innovations in care: neonatal home antibiotic infusion therapy.

Home care is replacing the traditional hospital stay for a variety of acute and chronic illnesses. The delivery of home antibiotic infusion therapy is an innovative treatment approach for stable term infants with suspected or confirmed infection. Neonates are a unique group of home i.v. therapy recipients, and programs specific to the needs of this population must be developed. This article describes one such program in detail.

Anti-Bacterial Agents↗