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. 2011 Jul 1;29(19):2683-8.
doi: 10.1200/JCO.2010.34.2816. Epub 2011 May 23.

Why do patients with cancer visit emergency departments? Results of a 2008 population study in North Carolina

Deborah K Mayer  1 , Debbie Travers, Annah Wyss, Ashley Leak, Anna Waller
Affiliations

Why do patients with cancer visit emergency departments? Results of a 2008 population study in North Carolina

Deborah K Mayer et al. J Clin Oncol. .

Abstract

Purpose: Emergency departments (EDs) in the United States are used by patients with cancer for disease or treatment-related problems and unrelated issues. The North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) collects information about ED visits through a statewide database.

Patients and methods: After approval by the institutional review board, 2008 NC DETECT ED visit data were acquired and cancer-related visits were identified. Descriptive statistics and logistic regressions were performed. Of 4,190,911 ED visits in 2008, there were 37,760 ED visits by 27,644 patients with cancer.

Results: Among patients, 77.2% had only one ED visit in 2008, the mean age was 64 years, and there were slightly more men than women. Among visits, the payor was Medicare for 52.4% and Medicaid for 12.1%. More than half the visits by patients with cancer occurred on weekends or evenings, and 44.9% occurred during normal hours. The top three chief complaints were related to pain, respiratory distress, and GI issues. Lung, breast, prostate, and colorectal cancers were identified in 26.9%, 6.3%, 6%, and 7.7% of visits, respectively, with diagnosis. A total of 63.2% of visits resulted in hospital admittance. When controlling for sex, age, time of day, day of week, insurance, and diagnosis position, patients with lung cancer were more likely to be admitted than patients with other types of cancer.

Conclusion: To the best of our knowledge, this is the first study to provide a population-based snapshot of ED visits by patients with cancer in North Carolina. Efforts that target clinical problems and specific populations may improve delivery of quality cancer care and avoid ED visits.

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Conflict of interest statement

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
2008 North Carolina (NC) emergency department (ED) visits by oncology patients, by (A) No. per type of clinic hours, (B) percentage per month, (C) percentage per day of the week, (D) No. per hour of day.
See this image and copyright information in PMC

References

    1. Hewitt M, Simone JV, editors. Ensuring Quality Cancer Care. Washington, DC: National Academies Press; 1999. - PubMed
    1. Barbera L, Paszat L, Chartier C. Indicators of poor quality end-of-life cancer care in Ontario. J Palliat Care. 2006;22:12–17. - PubMed
    1. Board on Health Care Services and Institute of Medicine. Hospital-Based Emergency Care: At the Breaking Point. Washington, DC: National Academies Press; 2006.
    1. Bozdemir N, Eray O, Eken C, et al. Demographics, clinical presentations and outcomes of cancer patients admitted to the emergency department. Turk J Med Sci. 2009;39:235–240.
    1. Barbera L, Taylor C, Dudgeon D. Why do patients with cancer visit the emergency department near the end of life? CMAJ. 2010;182:563–568. - PMC - PubMed

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