This has led to an interest in defining “avoidable” or “preventable” ED visits, though research on this is still in the early stages. EDs have continued to attract scrutiny as an inefficient and fragmentary site of care. While the number of ED visits per capita remained consistent between 20, costs have increased dramatically and crowding remains a persistent problem. ĮD use for patients with cancer reflects complex interactions between individual factors (e.g., insurance status, ability to use services), provider factors (e.g., knowledge, skills, communication, referrals, and access to specialists), health system factors (e.g., bed capacity), and policy factors (e.g., availability of social care). Patients with cancer may also present to the ED for conditions seemingly unrelated to their cancer (e.g., motor vehicle collisions, musculoskeletal injuries), but care for these patients is potentially complicated by cancer and its treatment. Notably, patients with cancer often incur multiple visits. Their reasons for ED visits range from time-sensitive emergencies to use of the ED as an entry point for a hospital admission. Patients with cancer present to the ED across the cancer survivorship continuum: at diagnosis, through treatment, post-treatment periods, and at the end-of-life (Fig. A 2017 National Health Service report from the UK emphasized dramatic increases in ED presentations related to cancer and concomitantly high rates of inpatient admission-often associated with poor patient experience, inadequate communication, and fragmented care coordination. Reports from Australia, the United Kingdom (UK), Brazil, and South Korea highlight similar concerns about the growing number of cancer patients and the increasing burden on EDs to manage disease- and treatment-related acute care. Furthermore, this rate is comparable to the proportion of visits related to congestive heart failure (4%), chronic kidney disease (3.5%), cerebrovascular disease including strokes (3.7%), and highly prevalent chronic conditions such as diabetes (6%). These visits tend to be of higher triage acuity and severity, especially among patients with concurrent co-morbid conditions and among older adults with complex care needs. Although this may not seem to be a high proportion, it represents a substantial number of visits amongst the extraordinary variety of conditions treated in EDs. With improving cancer treatments and survival, the primary and specialty care needs of cancer survivors will have substantial implications for health systems worldwide.Īpproximately 4% of all adult emergency department (ED) visits in the US are for cancer-related complaints. Furthermore, as global cancer incidence increases, the burden of cancer care is expected to fall increasingly on lower-income countries. Current estimates project dramatic increases in new cancer diagnoses, cancer survivorship, and costs of care. Globally, clinicians and policymakers are increasingly focused on improving the quality of cancer care by optimizing health care delivery. Given the amount and complexity of cancer care delivered in the emergency setting, future research is recommended to examine specific symptoms associated with cancer-related ED visits, the contextual determinants of ED use, and definitions of preventable ED use specific to patients with cancer.

ED use for patients with cancer likely reflects a complex interaction of individual and contextual factors-including provider behavior, health system characteristics, and health policies-that warrants greater attention in the literature. Similar patterns of cancer-related ED use are observed internationally across a range of different national payment and health system settings. Approximately 44% of cancer patients visit the ED within 1 year of diagnosis, and more often have repeat ED visits within a short time frame, though there is substantial variability across cancer types. The most recent population-based estimates suggest 4% of all ED visits are cancer-related and roughly two thirds of these ED visits result in hospitalization-a 4-fold higher ED hospitalization rate than the general population. This article describes the characteristics and determinants of ED visits, as well as challenges in the effort to define preventable ED visits in this population. Patients with cancer present to the ED across the cancer care continuum from diagnosis through treatment, survivorship, and end-of-life. The global prevalence of cancer is rapidly increasing and will increase the acute care needs of patients with cancer, including emergency department (ED) care.

Dameron hospital ed visits