The uncompensated costs associated with the evaluation and treatment of neutropenia

Abstract

6120 Background: Febrile neutropenia is a serous complication of chemotherapy which is frequently managed in the outpatient setting. Health care personnel provide many uncompensated services as they coordinate outpatient and home care services for this treatment-related complication. We performed a time and motion study designed to evaluate time spent and associated costs of uncompensated care provided by physicians, nurses, phlebotomists, and medical assistants for outpatient management of cancer chemotherapy-associated febrile neutropenia. Methods: Over a three month period, cancer chemotherapy-associated febrile neutropenia management activities of a small community medical practice were monitored. Tasks were categorized as: consultation/education, documentation, medication administration, test or medication ordering, phone calls, nursing, procedures, after hours follow-up, and miscellaneous. Unit costs were estimated using 2003 practice-specific salary and fringe benefit rates. Results: The results presented represent the time spent on the evaluation and management of neutropenia and related activities over the course of a 5 day work week. Conclusions: Based on the results of this observational study, the time required for coordination of chemotherapy-associated neutropenia management can be considerable, and the associated uncompensated costs to a small community practice can be substantial. For one community oncology practice, treatment and management of neutropenia and related care costs $88,832 of lost time per year. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Amgen; Medimmune Amgen