Assessing the outcomes of cancer patients in a home nursing program

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Abstract
The purpose of this paper is to analyze outcomes of 36 patients in a home nursing program who have a primary diagnosis of a malignant neoplasm. The means of analysis is the management information system of the Visiting Nurses Association of Metropolitan Atlanta. The three program outcome measures are functional status, hospitalization, and reason for discharge from the program. Results of the study indicated that the most successful outcome measure was hospitalization. Regardless of eventual outcome at discharge, including death, a considerable number of persons who were hospitalized before VNA service were able to avoid rehospitalization at discharge (21 of 30). This finding points to the potential “diversionary” effect of home nursing programs on cancer patients. Also, the program showed a decline in functional status from intake to discharge and a mortality rate of roughly 58 %. Three of the 36 patients were unable to be cared for in their homes and were moved to a skilled nursing facility. Analysis of the three outcomes by the location of the neoplasm showed some propensity toward greater success among those with cancers with a higher 5-year survival rate; however, because of the small sample, the authors feel that their results are exploratory rather than conclusive.

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