***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Many cystic fibrosis patients with Pseudomonas lung infections receive intravenous ( IV ) antibiotics and chest physiotherapy ( CPT ) at home . Previous studies have suggested that home care , in the setting of a clinical study , is as efficacious as hospital care . This report compares the outcomes of home care with minimal supervision to outcomes of hospital care . We compared two groups of similar age and severity of lung impairment . Patients met strict definitions for home or hospital treatment ( 27 home care courses/33 hospital care courses ) . Five patients completed six courses of both home care and hospital treatment .  Treatment in both groups included intravenous antibiotics and CPT . Primary outcome measures included changes in pulmonary function between the start of treatment and after 2 weeks of therapy , duration of treatment , and intervals between antibiotic courses . In hospitalized patients , forced vital capacity ( FVC ) increased by 17.4 + /- 3.1 % ( mean + /- SEM ) , and forced expiratory volume in one second ( FEV1 ) increased by 23.3 + /- 4.1 % , both significant at P < 0.001 . The FVC and FEV1 of patients treated at home increased by 10.2 + /- 2.0 % and 13.7 + /- 2.6 % respectively , neither of which was a significant improvement . Similar results were found in the five patients completing both home and hospital courses . The average duration of treatment was twice as long and time between IV antibiotic courses only two-thirds as long for those treated at home compared with the hospitalized patients . Previous reports have cl aim ed that home care in the setting of a prospect i ve study is as efficacious as hospital care . Our experience indicates that routine home care with minimal supervision of patients is less effective than hospital care . Furthermore , home care as delivered to patients in this report increased the overall cost of care by as much as 30 % because of longer and more frequent courses of antibiotic therapy METHODS 14 patients with cystic fibrosis and chronic pulmonary pseudomonas infection received four courses of two-week intravenous antibiotic therapy at home and during hospitalisation over an 18-month period . Following a controlled , intra-individual cross-over design , two courses of home therapy were followed by two courses of hospital treatment or vice versa . Parameters for inflammation , lung function , and body mass index were obtained at the beginning and end of each intravenous antibiotic therapy .  Health-related quality of life , i.e. physical , emotional , social and functional components as well as happiness and medical care , was assessed at the end of each course . RESULTS There was a trend towards better reduction of infection ( p = 0.20 for leukocyte reduction ) and improvement of lung function ( p = 0.20 for FEV1 improvement ) with hospital intravenous antibiotic therapy , although the differences did not attain statistical significance . Quality of life during therapy was significantly higher with home therapy regarding social ( p < 0.01 ) , functional and emotional subscales and happiness ( all p < 0.05 ) . The necessity for professional help and support from family and /or partner was emphasised . Individual answers showed that home therapy has the advantage of self-determination and continuity of daily life . Parents and partners felt impaired by day and night intravenous therapy at home . CONCLUSION From our data we conclude that home intravenous antibiotic therapy is a useful option for a selected subgroup of patients with cystic fibrosis , but professional support and family aid is important to gain an effect similar to hospital treatment In a prospect i ve , r and omised , cross-over study including cystic fibrosis patients with indications for HIVAT ( home intravenous antibiotic treatment ) the prospect of pharmaceutical intervention was investigated . A comparison between the use of disposable infusion devices with antibiotics from the pharmacy and when the patients prepared the drugs themselves was performed . During a first treatment course the patients received either infusion devices during 5 days or reconstituted the drugs themselves during 5 days , or vice versa . During a second treatment course the order was the reversed . Eight patients were included , out of which six completed the original design as a cross-over study , yielding a total of 550 doses of antibiotics . The patients preferred infusion devices from the pharmacy prepared according to GMP ( Good Manufacturing Practice ) as opposed to reconstituting the antibiotics themselves . Points of view presented included no anxiety over the correct dosage of drugs and less disruption of family and social life . In a practical sense , portable devices are more expensive than the preparation of the drugs by the patients themselves . However , when comparing with in-hospital treatment the direct costs for a hospital stay exceed that of the devices . Another part of the study evaluated the quality of life using a modified form of SEIQoL-DW ( Schedule for the Evaluation of Individual Quality of Life - Direct Weighting ) . Twenty patients took part in the study and the overall quality of life scores increased significantly when patients received infusion devices compared to reconstituting the drugs themselves A controlled prospect i ve study was undertaken to compare the efficacy and benefits of home and hospital treatment for patients with exacerbations of pulmonary disease caused by cystic fibrosis . A total of 41 home and 41 hospital treatments  were analyzed . Home and hospital patients were matched according to sex , age , pulmonary function tests , and arterial blood gas values . Both home and hospital treatments result ed in statistically significant improvement in pulmonary function . A comparison of these values did not show any statistically significant difference between groups at admission or discharge . Furthermore , the mean number of treatment days for both groups , individually determined by the primary physician , was equivalent ( home 17.7 + /- 1.1 days , hospital 18.1 + /- 4.1 ) . The mean charge for a home treatment was approximately $ 10,000 , and for a hospital treatment $ 18,000 . Sixty-five percent of home care patients and 68 % of hospital patients required retreatment for pulmonary exacerbations within the study period ; the interval between pulmonary exacerbations for the two groups was not significantly different . In addition , 85 % of patients receiving treatment at home were able to maintain at least some of their school or work activities . These data indicate that home therapy for cystic fibrosis patients with pulmonary exacerbations is less costly and is as effective as in-hospital therapy BACKGROUND Due to limited re sources within the health service and the continuous discussion on cost containment , economic criteria should also be considered when assessing therapy concepts . Particular results in terms of economic efficiency reserves are to be expected from a transfer of care from the in-patient to the out-patient sector . METHODS In a prospect i ve , direct cost recording of all relevant uses of re sources , the direct and indirect costs of the treatment of 14 patients with cystic fibrosis ( CF ) were included in the cross-over- design . The quality of life was recorded at least once for each patient using the EuroQol .  In-patient intravenous antibiotic therapy carried out during the block of out-patient care served as one of the disqualification criteria when selecting patients . RESULT Over an observation period of nine months , the average direct cost recorded were DM 35,706 for out-patient and DM 40,143 for in-patient treatment ( + 15 % ) . As far as indirect costs are concerned , the losses of production in the national economy recorded for in-patient treatment were 80 % higher . CONCLUSION The direct and indirect costs for in-patient CF-therapy are in total higher than for out-patient care . Whether these cost advantages have to be " bought " with lower medical effectiveness needs to be demonstrated by further clinical studies . In the sense of the disease management approach , the results of this study should be used to help rationally weigh up the costs of out-patient care against alternative treatment concepts 
    Output:
    
Home patients had fewer investigations performed than hospital patients ( p<0.002 ) and general activity was higher in the home group .
No differences were found for clinical outcomes , adverse events , complications of intravenous lines or line changes or time to next admission .
Home patients received less low-dose home maintenance antibiotic .
Quality of life measures showed no differences for dyspnoea and emotional state , but fatigue and mastery were worse for home patients , possibly due to a higher general activity and need of support .
Personal , family , sleeping and eating disruptions were less important for home than hospital admissions .
Home therapy was cheaper for families and the hospital .
It suggests that in the short term home therapy does not harm patients and in general reduces social disruptions .