# Hospital-at-home for oncology: treating low-risk febrile neutropenia and dehydration at home

Source: https://onco.cc/ideas/idea-acc-hospital-at-home-oncology/  
OnCo record `idea-acc-hospital-at-home-oncology` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Hospital-at-home programmes deliver intravenous antibiotics, fluids, monitoring and daily nurse and physician visits in the patient's home, with equivalent or better outcomes and lower costs in general medicine. Extending them to low-risk fever after chemotherapy and dehydration, with payer recognition, would keep older cancer patients out of hospital beds, where they are most at risk of harm.

## Summary

Hospital-at-home programmes deliver acute-level care (IV antibiotics, fluids, monitoring, daily nurse and physician oversight) in the patient's home and have shown equivalent or better outcomes, fewer complications, and lower costs in general medicine. Oncology-specific programmes (such as Huntsman at Home) report reduced admissions and emergency visits. Expanding the model to defined oncology conditions, with payer recognition, would reduce hospitalisation, which is particularly harmful for older patients.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Oncology hospital-at-home will reduce inpatient bed-days for eligible conditions by at least 40% with no increase in 30-day mortality or escalation, and higher patient satisfaction.
- Rationale: Hospital stays cause deconditioning, delirium, and infection in older patients; the interventions for many oncology admissions are deliverable at home.
- Proposed test: A randomised trial of hospital-at-home versus admission for low-risk febrile neutropenia, dehydration, and symptom crises in 500 patients with bed-days, safety, and satisfaction as endpoints.
- Maturity: being-tested-at-scale
- Actor: clinic

## Sources

- Bottleneck evidence (Older and multimorbid patients are excluded and undertreated): Mohile et al., Evaluation of geriatric assessment and management on toxic effects of cancer treatment (GAP70+, Lancet 2021): https://doi.org/10.1016/S0140-6736(21)01789-X

## Connected records

- ideas: [Acute oncology assessment units so sick cancer patients bypass the emergency department](https://onco.cc/ideas/idea-acc-acute-oncology-assessment-units/)
- fronts: [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- bottlenecks: [Fragmented care and guideline gaps](https://onco.cc/bottlenecks/b-care-fragmentation/), [Older and multimorbid patients are excluded and undertreated](https://onco.cc/bottlenecks/b-aging-comorbidity/), [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)

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