Effective Patient Selection for an Oncology-Dedicated Emergency Service: A Retrospective Study
| Autor: | Gil Bar-Sela, Ilit Turgeman |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Service (business)
Oncology (nursing) business.industry Health Policy MEDLINE Retrospective cohort study medicine.disease 03 medical and health sciences 0302 clinical medicine Patient burden Oncology 030220 oncology & carcinogenesis Health care Emergency medical services medicine 030212 general & internal medicine Medical emergency business Selection (genetic algorithm) |
| Zdroj: | JCO Oncology Practice. 17:e1567-e1575 |
| ISSN: | 2688-1535 2688-1527 |
| DOI: | 10.1200/op.20.01081 |
| Popis: | PURPOSE: Emergency cancer care constitutes a significant health care and patient burden. The purpose of this study was to identify characteristics of patients most fitting for treatment in an oncology-dedicated emergency department (OED). METHODS: Electronic files of patients with cancer seeking emergency services between April and June 2017 were retrospectively obtained from the hospital registry. Efficacy parameters were compared between patients treated in the OED and those treated in the general emergency department (GED). Using descriptive statistics and logistic regressions, patient- and treatment-related factors were correlated with effective care in the OED. RESULTS: More than half of the total 799 patients presented initially to the OED, of which 10.4% required GED referral. Treatment in the GED was associated with a higher rate of consultations, imaging, and hospitalization ( P < .001), with the cost of imaging alone four times that of the OED ($23,263 US dollars difference). The relative proportion of patients with cancer visiting the GED was reduced after founding the OED. In the OED, patient diagnoses included lung (33%), GI, and breast cancer, of which 85% were metastatic. Frequent chief complaints were pain (45%), GI, malaise, and respiratory symptoms. Referral to the GED was significant in those with genitourinary cancer, back pain ( P < .001), and neurologic symptoms, on biologic therapy, and with suspected oncological emergencies; conversely, disease symptoms (30% admissions) were well-controlled in the OED ( P = .003). CONCLUSION: Using minimal resources, the OED provides efficacious, cancer-focused care, suitable for the majority of acute admissions. Careful triage is recommended, as high-risk patients should be referred to the GED, where advanced multidisciplinary management is more readily available. |
| Databáze: | OpenAIRE |
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