Healthcare personnel provide many uncompensated services in coordinating outpatient and home care services for patients with chemotherapy-associated febrile neutropenia. A time-and-motion study at a two-oncologist community practice was completed over a 3-month period. Time spent on various uncompensated tasks associated with the outpatient management of cancer chemotherapy-associated neutropenia and the associated estimated costs of this care were evaluated. Unit costs were based on 2003 practice-specific salary and fringe-benefit rates. Mean weekly time and cost estimates for management of chemotherapy-associated febrile neutropenia included 12.4 hours by physicians ($1,550), 4.7 hours by nurses ($108), 1.7 hours by medical assistants ($23), and 1.4 hours by phlebotomists ($27). Overall uncompensated outpatient care for management of febrile neutropenia averaged $1,708 per week, or $88,816 per year. Time-motion methodologies can be used to derive estimates of the uncompensated time required for coordination of chemotherapy-associated neutropenia management. This pilot study suggests that-for a small community oncology practice-these costs can be considerable.
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