May 5, 1994
Media Contact:Gary Stephenson
Phone: (410) 955-5384

Medicare reimbursements for cancer therapy often shortchange healthcare providers because the payments do not reflect the costs of additional care required to treat side effects of the therapy itself, according to results of a study at The Johns Hopkins University School of Nursing.

The study's findings, based on data from more than 3,000 cancer patients with more than 8,000 hospitalizations, explain why some patients spend more time in the hospital than Medicare considers appropriate, under its so-called DRG or Diagnostic Related Group schedule, says Catherine Kelleher, Sc.D., M.P.H., M.S., R.N., assistant professor at the School of Nursing. DRGs offer standardized length of stay and cost guidelines for hundreds of conditions in an effort to eliminate unnecessarily long hospital stays and treatment.

To study the impact of side effects on length and cost of hospitalization, Kelleher developed a Treatment Toxicity Index (Tn), which measures the short-term side effects of cancer treatment.

"The study provides objective clinical evidence that services for treatment-induced illness need to be reimbursed," she says.

Assisted by a panel of physicians and nurses from the Johns Hopkins Oncology Center, Kelleher used laboratory data related to treatment-linked illness. The data included body temperature, and the results of 14 laboratory tests measuring function of all major organ systems and used by U.S. cooperative oncology groups for monitoring toxicity of treatment.

Kelleher said the next step is to test the Treatment Toxicity Index in cancer centers and other hospitals throughout the country.

The study was first presented at an American Cancer Society seminar for science writers in March.

Kelleher is director of the M.S.N./M.P.H. joint degree program at The Johns Hopkins University School of Nursing and holds a joint appointment in oncology at the School of Medicine. She also holds a joint appointment in the Department of Health Policy and Management at the School of Public Health. Support for her research came from the National Institute of Nursing Research and the National Cancer Institute.

-- JHMI --
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