Future studies will focus on individual physician-level decisions and identify and evaluate patterns in oncology patient management. Recent research by my colleagues and myself found that lower-acuity ED visits could be addressed in an urgent care setting, thereby lowering the number of ED visits by oncology patients. I think it’s simply a matter of integrating it better, making it more visible to patients and their families, and figuring out how we can optimize and reduce ED visit use.įurther research is needed to better characterize and develop strategies to improve oncology-related ED care. Our urgent care use research is relevant to clinicians because we know this gap can be filled. 01), patients were discharged home more often if clinical contact came before ED visits (aOR of hospitalization 0.82 95% CI, 0.74-0.90). Although clinical severity was slightly greater for ED visits without prior clinical contact (46% vs. More than two-thirds of all ED visits arose without prior clinical contact (70.2% PHHS, 66.7% UTSW). The study matched 8,289 Parkland (54% female, 78% Medicaid/charity assistance) and 10,817 UTSW patients (50% female, 12% Medicaid), who had 21,009 and 22,696 ED visits, respectively. A mixed-effects multivariate logistic regression clustering was used at the patient level to model ED disposition after a pre-ED clinical contact. We evaluated how frequently patients visit the ED without obtaining prior clinical advice and compared ED visit severity between patients with and without preceding clinical advice. In a recent study, my team collected and retrospectively analyzed the electronic health records of adult oncology patients from Parkland Health & Hospital System (PHHS), the Dallas County public safety net system, and the UT Southwestern (UTSW) NACR Gold-Certified cancer registry (2012-2018). However, patterns of care in these clinics remain largely unknown. ![]() As a result, various hospitals have developed oncology urgent care clinics. Medicare’s Oncology Care Model alternative payment program provides 24-hour patient access to telephone consultation with a clinician. ![]() Įxamining Care Patterns Before an Emergency Department Visit As the number of oncology patients visiting the ED rises each year, a closer analysis is needed to better understand why oncology patients are using the ED. The report Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis identified several factors that contribute to high-quality cancer care, with the substantial costs of delivering treatment and fragmentation of service noted as key barriers. In 2020, it is estimated that the costs for cancer care will be a staggering $173 billion. Optimal patient care needs to be delivered in a safe and high-quality manner, which can be demanding for ED clinicians, given the dynamic complexities of oncology care, diverse patient populations, and ongoing demands of the ED setting. ![]() Specialized care is often required, and dependent upon the type, stage, and location of disease. Potential strategies for reducing visits include managing symptoms, ensuring correct treatment regimens, and properly managing care. While the use of acute care settings is often warranted, a substantial proportion of these visits might be preventable. Oncology patients frequently visit the emergency department (ED) for various health concerns and other disease-related comorbidities. Researchers at UT Southwestern are working to identify patient-oriented alternatives to better optimize ED visits and clinical care.
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