Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May;13(4):367-378.
doi: 10.6004/jadpro.2022.13.4.2. Epub 2022 Jun 21.

Evaluation of Emergency Department Visits by Oncology Patients: A Running Comparison to Admissions and ED Visits Under the CMS OP-35 Ruling

Nada Alsuhebany  1   2   3 , Jamie Brown  4 , Jacquelyne Echave  5 , Ali McBride  5
Affiliations

Evaluation of Emergency Department Visits by Oncology Patients: A Running Comparison to Admissions and ED Visits Under the CMS OP-35 Ruling

Nada Alsuhebany et al. J Adv Pract Oncol. 2022 May.

Abstract

Background: Cancer is the second leading cause of death in the United States. The incidence of emergency department (ED) visits by oncology patients has grown over the past years. Some ED visits are medically unnecessary and could be prevented with improved prevention measures.

Objectives: To evaluate the incidence and causes of ED visits by cancer patients and evaluate outcomes and disposition of ED visits.

Methods: This single-center, retrospective chart review was conducted in a tertiary medical hospital. We collected data using an electronic medical record and included oncology patients with active cancer who had ED visits from January 1, 2018, to December 31, 2018. Key data collection included baseline demographics; type of malignancy; main chief complaint; clinic visit history; current and past ED visits; treatment and supportive care data; and disposition status if admitted. Pregnant patients, patients without active cancer, and patients who received outpatient care at clinics other than the University of Arizona Cancer Center were excluded.

Results: This chart review study screened 1,659 encounters and included 205 encounters. Approximately 70% of the encounters were solid tumor patients and 30% were hematologic malignancies. Nearly 50% of the patients with hematologic malignancies had preventable ED visits while 32.8% of solid tumor patients had preventable ED visits. The most common preventable ED visit reasons in both groups were pain, fever, nausea, vomiting, and dehydration. Almost 50% of the patients in both groups were hospitalized with a median length of stay of 3 days. The majority of admitted patients were discharged home in both the solid tumor (82.3%) and hematologic malignancy (83.8%) groups.

Conclusion: This study showed that the rate of preventable visits was numerically higher in the hematologic cancer group compared with the solid tumor group. These findings highlight the potential need for implementing prevention measures in the future.

PubMed Disclaimer

Conflict of interest statement

Dr. McBride has served on the advisory board for Bristol Myers Squibb and speakers bureau for Sanofi. The other authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flowsheet of the study screening and inclusion.
Figure 2
Figure 2
Hospital admissions in past year.
Figure 3
Figure 3
ED visits in past year.
Figure 4
Figure 4
(A) Use of supportive care in patients with solid tumors. (B) Use of supportive care in patients with hematologic malignancies. G-CSF = granulocyte colony-stimulating factor.
See this image and copyright information in PMC

References

    1. Board Advisory. (2016). CMS proposes outcomes-based quality measure for outpatient cancer care. https://www.advisory.com/research/oncology-roundtable/oncology-rounds/20...
    1. Barnes, G., Pathak, A., & Schwartzberg, L. (2014). G-CSF utilization rate and prescribing pattern in the United States: Associations between physician and patient factors and G-CSF use. Cancer Medicine, 3(6), 1477–1484. 10.1002/cam4.344 - DOI - PMC - PubMed
    1. Broder, M. S., Faria, C., Powers, A., Sunderji, J., & Cherepanov, D. (2014). The impact of 5-HT3RA use on cost and utilization in patients with chemotherapy-induced nausea and vomiting: Systematic review of the literature. American Health & Drug Benefits, 7(3), 171–182. https://pubmed.ncbi.nlm.nih.gov/24991400/ - PMC - PubMed
    1. Brown, J., Grudzen, C., Kyriacou, D. N., Obermeyer, Z., Quest, T., Rivera, D., & Shelburne, N. (2016). The emergency care of patients with cancer: Setting the research agenda. Annals of Emergency Medicine, 68(6), 706–711. 10.1016/j.annemergmed.2016.01.021 - DOI - PMC - PubMed
    1. Burris, H. A., Belani, C. P., Kaufman, P. A., Gordon, A. N., Schwartzberg, L. S., Paroly, W. S., & Saven, A. (2010). Pegfilgrastim on the same day versus next day of chemotherapy in patients with breast cancer, non–small-cell lung cancer, ovarian cancer, and non-Hodgkin's lymphoma: Results of four multicenter, double-blind, randomized phase II studies. Journal of Oncology Practice, 6(3), 133–140. 10.1200/jop.091094 - DOI - PMC - PubMed

LinkOut - more resources