Gianmauro Numico1, Cristian Zanelli2, Roberto Ippoliti3, Maura Rossi4, Elena Traverso4, Andrea Antonuzzo5, Roberta Bellini2. 1. Medical Oncology Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. Electronic address: gianmauro.numico@ospedale.al.it. 2. Quality and Management Control Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. 3. University of Bielefeld, Department of Business Administration and Economics, Bielefeld, Germany. 4. Medical Oncology Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. 5. Medical Oncology Unit 1, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Abstract
PURPOSE: Hospital admission is a frequent occurrence among patients with cancer, and a significant proportion of patients admitted to medical units have cancer. Their hospital stay has features that may be different compared with patients without cancer. We performed a retrospective analysis of the characteristics of patients with cancer admitted for medical conditions. PATIENTS AND METHODS: We studied the administrative data of patients with solid cancer admitted to the medical department of a large referral hospital over a 12-month period and compared them with those of patients without cancer. RESULTS: Seven thousand eight hundred two consecutive admissions were analysed, of which 1099 (14.1%) had a principal or associated diagnosis of cancer. Admissions were distributed across 12 units, with 44% concentrated in the medical oncology unit and 56% in other units. Patients with cancer were more frequently men and were younger than patients without cancer. Admission less frequently involved the emergency department (ED), while discharge was more frequently assisted. The in-hospital death rate was higher, as was the readmission rate. Length of stay was longer (11.3 days vs. 9.8 days; p < 0.0001). Patients with cancer admitted to the medical oncology unit used the ED even less, and their length of stay was shorter than that of patients with cancer admitted in other units. CONCLUSIONS: The in-hospital pathway of patients with cancer displays specific issues and adds complexity to hospital stay of patients with medical conditions. The medical oncology unit plays a role in reducing ED use and in providing efficient care. The evidence gathered should help in shaping new models of care and in improving adequate clinical competencies.
PURPOSE: Hospital admission is a frequent occurrence among patients with cancer, and a significant proportion of patients admitted to medical units have cancer. Their hospital stay has features that may be different compared with patients without cancer. We performed a retrospective analysis of the characteristics of patients with cancer admitted for medical conditions. PATIENTS AND METHODS: We studied the administrative data of patients with solid cancer admitted to the medical department of a large referral hospital over a 12-month period and compared them with those of patients without cancer. RESULTS: Seven thousand eight hundred two consecutive admissions were analysed, of which 1099 (14.1%) had a principal or associated diagnosis of cancer. Admissions were distributed across 12 units, with 44% concentrated in the medical oncology unit and 56% in other units. Patients with cancer were more frequently men and were younger than patients without cancer. Admission less frequently involved the emergency department (ED), while discharge was more frequently assisted. The in-hospital death rate was higher, as was the readmission rate. Length of stay was longer (11.3 days vs. 9.8 days; p < 0.0001). Patients with cancer admitted to the medical oncology unit used the ED even less, and their length of stay was shorter than that of patients with cancer admitted in other units. CONCLUSIONS: The in-hospital pathway of patients with cancer displays specific issues and adds complexity to hospital stay of patients with medical conditions. The medical oncology unit plays a role in reducing ED use and in providing efficient care. The evidence gathered should help in shaping new models of care and in improving adequate clinical competencies.