OBJECTIVES: In France, most cancer treatments are given in a hospital (medical, surgical and obstetrics - MSO). Several recommendations were developed by the French HTA to develop the use of home hospitalization (HH) to reduce the burden of cancer disease management on hospital and follow the aspirations of elderly patient to be maintaining at home.

The objective of this study is to evaluate the factors impacting the dispensation of cancer treatment (CT) in HH vs in MSO.

METHODS: This is a retrospective study based on French national claims database (PMSI). All adult patients diagnosed with bronchopulmonary cancer (ICD10 C34) and having a hospitalization (MSO or HH) with administration of a CT between 2016 and 2021 were included.

The impact of patient’s characteristics (age, gender, comorbidities, region of residence), type of treatment, distance to the hospital, and type of hospital (public, private) on the type of hospitalization (HH vs MSO) were evaluated using a multivariate logistic regression model with forward stepwise selection of the variables.

RESULTS: 167,585 patients (99,6 % with MSO) were included, mean age of 66 years old (±10) and 48% were women.

The probability of being in HH was significantly higher for women patients with severe comorbidities (diabetes, cardiovascular diseases, other cancer) and for patients managed by public hospitals. The use of innovative and costly immunotherapy or chemotherapy, and radiotherapy were significantly associated with a poor probability of HH. Large disparities were observed in these results according to the region of residence considered.

CONCLUSIONS: This study provided a national understanding of the disparity in the development of HH in the management of the bronchopulmonary cancer according to patient characteristics, treatments administered and the region of residence. These trends could be considered in the orientation of public health policies to support the development of HH in France.