The objective of this project is to provide outpatient support for research investigations of the program. An increasing proportion of cost effective care of the stem cell recipient is provided in ambulatory settings at the transplant center and home community. To facilitate research activities at these sites, we propose to support patient entry, participation and compliance in research studies and treatments in the outpatient department. Although prior randomized studies have demonstrated safety and a reduction in total hospital days and inpatient charges by early discharge to enhanced ambulatory care, pilot data of early discharge home from the transplant center suggest an increase in subsequent hospital utilization. Accordingly, we propose to determine in a controlled manner the effect on patient recovery, hospitalizations and charges of early discharge from the transplant center. Finally, we propose to improve patient outcome after return home by development of a knowledge base technology to facilitate information transfer and guide interactions between primary care providers and athe transplant team.
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