OBJECTIVES: Home hospitalization (HH) for oncological patients is an innovative approach to offer patient-centered care. However, little information is available on the costs and preferences of HH. The aim of this study was twofold. First, the study investigated the costs for the providers and the current funding from the national health insurance (NHI) of HH and the standard of care (SOC). Second, the patient’s experiences and preferences of HH was compared to the SOC. Two HH models were examined in three Belgian hospitals and three home nursing organizations. In a first HH model (HH1), the blood draw and monitoring prior to intravenous therapy was performed by a trained home nurse at the patient’s home the day before the visit to the day hospital. In a second HH model (HH2), the administration of two subcutaneous treatments was partly provided at home instead of in the hospital.

METHODS: (1) A bottom-up micro-costing study was conducted to compare the costs and revenues and (2) a cross-sectional survey was performed to compare patient’s experiences and preferences of the SOC group and the HH group.

RESULTS: The study revealed that providers’ costs of HH are higher than the SOC. The costs in HH1 are on average €50.4/visit higher. In HH2, the average costs are €9.7/visit higher, due to the travel time of the nurse to administer the chemo at home. The comparison of revenues with costs revealed that the current funding from NHI of HH is insufficient. HH patients prefer HH and none of them wanted to return to SOC, although satisfaction of patients was not significantly different between the two categories.

CONCLUSIONS: This study shows that HH patients prefer HH. However, the funding from NHI is insufficient to organize HH. As a result, HH for oncology patients is still limited in Belgium.