Associated factors and costs of avoidable visits to the emergency department among cancer patients

1-year experience in a tertiary care hospital in South Korea

Tak Kyu Oh, You Hwan Jo, Jae Wook Choi

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalSupportive Care in Cancer
DOIs
Publication statusAccepted/In press - 2018 May 8

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Republic of Korea
Tertiary Healthcare
Tertiary Care Centers
Hospital Emergency Service
Costs and Cost Analysis
Neoplasms
Odds Ratio
Confidence Intervals
Korea
Palliative Care
Medical Records

Keywords

  • Avoidable hospital visits
  • Cancer care
  • Emergency care
  • Emergency department
  • Palliative care

ASJC Scopus subject areas

  • Oncology

Cite this

@article{68bd9af62e524ab5a58362c5c938e50e,
title = "Associated factors and costs of avoidable visits to the emergency department among cancer patients: 1-year experience in a tertiary care hospital in South Korea",
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.",
keywords = "Avoidable hospital visits, Cancer care, Emergency care, Emergency department, Palliative care",
author = "Oh, {Tak Kyu} and Jo, {You Hwan} and Choi, {Jae Wook}",
year = "2018",
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day = "8",
doi = "10.1007/s00520-018-4195-0",
language = "English",
pages = "1--9",
journal = "Supportive Care in Cancer",
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T1 - Associated factors and costs of avoidable visits to the emergency department among cancer patients

T2 - 1-year experience in a tertiary care hospital in South Korea

AU - Oh, Tak Kyu

AU - Jo, You Hwan

AU - Choi, Jae Wook

PY - 2018/5/8

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N2 - 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.

AB - 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.

KW - Avoidable hospital visits

KW - Cancer care

KW - Emergency care

KW - Emergency department

KW - Palliative care

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