Better symptom management and readily available outpatient care for patients with cancer can reduce emergency department (ED) visits that do not require admission by as much as 53%, according to a recent study.
-----
Related Content
ED Use, Hospitalizations High Among Patients With Parkinson’s Disease
Special clinics for childhood cancer survivors may cut ER visits
-----
Numerous studies have examined the rate of ED visits among patients treated for cancer. However, no investigations have identified potentially preventable ED visits during treatment.
Laura Panattoni, PhD, staff scientist, Hutchinson Institute for Cancer Outcomes Research, and colleagues conducted a study that followed patients across 13 counties in Washington state with solid tumors to test for potentially preventable ED visits. A total of 5853 commercially insured patients were sampled who were treated with chemotherapy, radiation, or both. Among this cohort of patients, 27% (n = 1581) visited the ED without being admitted within 12 months of treatment initiation.
Researchers identified 2400 ED visits among these 1581 patients and then sought to determine whether they could have been prevented. Findings from their analysis were presented at the 2017 ASCO Annual Meeting (June 2-6, 2017; Chicago, IL).
Utilizing a federally-insured list of preventable symptoms—combined with symptoms targeted by patient-reported outcome tools—researchers found that approximately 53% of these ED visits were due to symptoms that could be managed with timely care in an outpatient setting. Additionally, the rate increased to 70% when researchers expanded the standard to include other common patient complaints and symptoms associated with chronic health conditions.
Furthermore, the study indicated a higher median cost per ED visit for patients with cancer with preventable symptoms ($1047) compared with the cost of ED visits resulting from other chronic health conditions ($335).
“At a time when federal authorities and private payers are linking insurance payments to hospital quality measures, this study points to the importance of developing methods to accurately identify those emergency department visits that are preventable versus those that are appropriate,” Dr Panattoni commented in her presentation.
To address these preventable patient symptoms, Dr Panattoni and colleagues recommended oncology medical homes and cancer-specific urgent care centers as appropriate resources.—Zachary Bessette
