Infusing Safety: Comparing Oncology Infusion Outcomes at Home Infusion Services vs. Hospital-Based Outpatient Infusion Centers

Background Oncology infusions are a cornerstone of cancer treatment, often administered in hospitalbased outpatient departments (HOPDs) due to the controlled environment they offer. However, with the rise of patient-centered care and cost reduction efforts, home infusion services are an increasingly viable alternative for oncology treatments, though some professional groups have concerns about safety. To address these concerns, this study compares safety outcomes of oncology infusions administered through home infusion (HI) to those administered in HOPDs. Methods This retrospective study analyzed data from adult oncology patients who received infusion therapies between January 2020 and December 2023 through HI or HOPDs within a single health system. Primary outcomes included infusion-related reactions (IRRs), all-cause acute care visits within 48-hours, and respiratory infection (influenza, COVID-19, RSV) rates within 14-days following infusions. Chi-square tests compared patient characteristics and infusion outcomes by site of care. Results There were 3,084 patients (38,052 infusions) treated in HOPDs and 145 patients (1,242 infusions) treated through HI; 93 (3.0%) patients were treated at both sites. Patients receiving HI were younger (Under 50 years: HI: 36 (69.2%) vs. HOPD: 486 (16.2%), p < 0.0001) and more likely to be female (HI: 34 (65.4%) vs. HOPD: 1,723 (57.4%), p = 0.049). Rates of IRRs and acute care utilization were similar following infusions at both sites of care (IRRs: HI: 0.16% vs. HOPD: 0.19%, p = 0.81; Acute care visits: HI: 1.4% vs. HOPD: 1.2%, p = 0.47). There were fewer respiratory infections reported following HIs compared to HOPD infusions (HI: 0 (0.0%) vs. HOPD: 144 (0.38%), p = 0.029). Conclusion These findings indicate that oncology infusions occurring within HI result in safety outcomes comparable to HOPDs; further, there were fewer respiratory infections, which can be life-threatening among oncology patients, following HI. Home infusion has the potential to enhance patient-centered care and maintain high safety standards, while also providing comfortable, convenient therapy for patients. This knowledge may aid oncologists in making informed and personalized decisions with their patients regarding site of care and resource allocation.