Tak Kyu Oh1, You Hwan Jo2, Jae Wook Choi3,4. 1. Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Bundang, South Korea. 2. Department of Emergency Medicine, Seoul National University Bundang Hospital, Bundang, South Korea. 3. Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea. shine@korea.ac.kr. 4. Institute for Occupational and Environmental Health, Korea University, 145 Anam-ro, Anam-dong, Seoul, Seongbuk-gu, South Korea. shine@korea.ac.kr.
Abstract
PURPOSE: Patients receiving palliative care make avoidable emergency department visits (AvED), which may increase economic and social costs. However, the proportion of AvED among all patients, including cancer patients after curation, and the resulting costs are unknown in Asia. This study aimed to investigate the proportion, characteristics, and costs regarding factors associated with AvED among cancer patients. METHODS: This retrospective cohort study analyzed the medical records of patients who visited the emergency department (ED) at a tertiary care hospital in Korea in 2016. Data regarding patients' demographic, cancer-related, and clinical characteristics were collected. RESULTS: ED visits by a total of 4346 patients were included in the analysis, of which 2420 visits (55.7%) were avoidable. In the multivariate logistic model, the following main factors were associated with AvED: stay in ED (odds ratio [OR] 0.998, 95% confidence interval [CI] 0.997-0.999, P < 0.001), distance to the home from the ED (OR 0.998, 95% CI 0.997-0.999, P < 0.001), multiple ED visits in 1 year (OR 1.204, 95% CI 1.156-1.255, P < 0.001), primary progression (vs. after curation) (OR 0.748, 95% CI 0.627-0.892, P = 0.001), and chief complaint being a gastrointestinal symptom (vs. pain) (OR 1.871, 95% CI 1.188-2.946, P = 0.007). The average cost per visit in the AvED group was $369.80, and the annual total cost for all AvEDs was $894,877. CONCLUSIONS: Our study showed that 55.7% of all ED visits by cancer patients visiting the ED of a tertiary care hospital were avoidable, and several factors were associated with AvED.
PURPOSE:Patients receiving palliative care make avoidable emergency department visits (AvED), which may increase economic and social costs. However, the proportion of AvED among all patients, including cancerpatients after curation, and the resulting costs are unknown in Asia. This study aimed to investigate the proportion, characteristics, and costs regarding factors associated with AvED among cancerpatients. METHODS: This retrospective cohort study analyzed the medical records of patients who visited the emergency department (ED) at a tertiary care hospital in Korea in 2016. Data regarding patients' demographic, cancer-related, and clinical characteristics were collected. RESULTS: ED visits by a total of 4346 patients were included in the analysis, of which 2420 visits (55.7%) were avoidable. In the multivariate logistic model, the following main factors were associated with AvED: stay in ED (odds ratio [OR] 0.998, 95% confidence interval [CI] 0.997-0.999, P < 0.001), distance to the home from the ED (OR 0.998, 95% CI 0.997-0.999, P < 0.001), multiple ED visits in 1 year (OR 1.204, 95% CI 1.156-1.255, P < 0.001), primary progression (vs. after curation) (OR 0.748, 95% CI 0.627-0.892, P = 0.001), and chief complaint being a gastrointestinal symptom (vs. pain) (OR 1.871, 95% CI 1.188-2.946, P = 0.007). The average cost per visit in the AvED group was $369.80, and the annual total cost for all AvEDs was $894,877. CONCLUSIONS: Our study showed that 55.7% of all ED visits by cancerpatients visiting the ED of a tertiary care hospital were avoidable, and several factors were associated with AvED.
Entities:
Keywords:
Avoidable hospital visits; Cancer care; Emergency care; Emergency department; Palliative care
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