Building a Supportive Oncology Practice that Impacts Emergency Department Visits, Hospice Utilization, and Hospital Admission

2018 ◽  
Vol 21 (10) ◽  
pp. 1499-1503 ◽  
Author(s):  
Bethann Scarborough ◽  
Suzanne Goldhirsch ◽  
Emily Chai
Keyword(s):  
Emergency Department ◽  
Hospital Admission ◽  
Emergency Department Visits ◽  
Supportive Oncology ◽  
Oncology Practice

scholarly journals Emergency Department Visits During Outpatient Parenteral Antimicrobial Therapy: A Cohort Study

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S333-S334
Author(s):  
So Lim Kim ◽  
Angela Everett ◽  
Susan J Rehm ◽  
Steven Gordon ◽  
Nabin Shrestha
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Hospital Admission ◽  
Vascular Access ◽  
Antimicrobial Therapy ◽  
Cleveland Clinic ◽  
Emergency Department Visits ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Ed Visits ◽  
Access Complications

Abstract Background Outpatient parenteral antimicrobial therapy (OPAT) carries risk of vascular access complications, antimicrobial adverse effects, and worsening of infection. Both OPAT-related and unrelated events may lead to emergency department (ED) visits. The purpose of this study was to describe adverse events that result in ED visits and risk factors associated with ED visits during OPAT. Methods OPAT courses between January 1, 2013 and December 31, 2016 at Cleveland Clinic were identified from the institution’s OPAT registry. ED visits within 30 days of OPAT initiation were reviewed. Reasons and potential risk factors for ED visits were sought in the medical record. Results Among 11,440 OPAT courses during the study period, 603 (5%) were associated with 1 or more ED visits within 30 days of OPAT initiation. Mean patient age was 58 years and 57% were males. 379 ED visits (49%) were OPAT-related; the most common visit reason was vascular access complication, which occurred in 211 (56%) of OPAT-related ED visits. The most common vascular access complications were occlusion and dislodgement, which occurred in 99 and 34 patients (47% and 16% of vascular access complications, respectively). In a multivariable logistic regression model, at least one prior ED visit in the preceding year (prior ED visit) was most strongly associated with one or more ED visits during an OPAT course (OR 2.96, 95% CI 2.38 – 3.71, p-value < 0.001). Other significant factors were younger age (p 0.01), female sex (p 0.01), home county residence (P < 0.001), and having a PICC (p 0.05). 549 ED visits (71%) resulted in discharge from the ED within 24 hours, 18 (2%) left against medical advice, 46 (6%) were observed up to 24 hours, and 150 ED visits (20%) led to hospital admission. Prior ED visit was not associated with hospital admission among patients who visited the ED during OPAT. Conclusion OPAT-related ED visits are most often due to vascular access complications, especially line occlusions. Patients with a prior ED visit in the preceding year have a 3-fold higher odds of at least one ED visit during OPAT compared with patients without a prior ED visit. A strategy of managing occlusions at home and a focus on patients with prior ED visits could potentially prevent a substantial proportion of OPAT-related ED visits. Disclosures All authors: No reported disclosures.

Primary diagnoses and outcomes of emergency department visits in older people with dementia: a hospital-based retrospective study in Taiwan

2019 ◽  
Vol 32 (1) ◽  
pp. 97-104
Author(s):  
Pei-Chao Lin ◽  
Li-Chan Lin ◽  
Hsiu-Fen Hsieh ◽  
Yao-Mei Chen ◽  
Pi-Ling Chou ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Retrospective Study ◽  
Older People ◽  
Hospital Admission ◽  
Emergency Department Visits ◽  
Urban Setting ◽  
Research Database ◽  
Patient Records ◽  
People With Dementia

ABSTRACTObjectives:The objectives of this study were to investigate the primary diagnoses and outcomes of emergency department visits in older people with dementia and to compare these parameters with those in older adults without dementia.Design and Setting:This hospital-based retrospective study retrieved patient records from a hospital research database, which included the outpatient and inpatient claims of two hospitals.Participants:The patient records were retrieved from the two hospitals in an urban setting. The inclusion criteria were all patients aged 65 and older who had attended the two hospitals as an outpatient or inpatient between January 1, 2009, and December 31, 2016. Patients with dementia were identified to have at least three reports of diagnostic codes, either during outpatient visits, during emergency department visits, or in hospitalized database records. The other patients were categorized as patients without dementia.Measurements:The primary diagnosis during the emergency department visit, cost of emergency department treatment, cost of hospital admission, length of hospital stay, and diagnosis of death were collected.Results:A total of 149,203 outpatients and inpatients aged 65 and older who were admitted to the two hospitals were retrieved. The rate of emergency department visits in patients with dementia (23.2%) was lower than that in those without dementia (48.6%). The most frequent primary reason for emergency department visits and the main cause of patient death was pneumonia. Patients with dementia in the emergency department had higher hospital admission rates and longer hospital stays; however, the cost of treatment did not show a significant difference between the two groups.Conclusions:Future large and prospective studies should explore the severity of disease in older people with dementia and compare results with older adults without dementia in the emergency department.

scholarly journals Emergency Department Visits and Subsequent Hospital Admission Trends for Patients with Chest Pain and a History of Coronary Artery Disease

2020 ◽  
Vol 9 (1) ◽  
pp. 153-165 ◽  
Author(s):  
Christine Eichelberger ◽  
Aarti Patel ◽  
Zhijie Ding ◽  
Christopher D. Pericone ◽  
Jennifer H. Lin ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Emergency Department ◽  
Chest Pain ◽  
Coronary Artery ◽  
Hospital Admission ◽  
Emergency Department Visits ◽  
History Of ◽  
Artery Disease

scholarly journals Inpatient Readmissions and Emergency Department Visits within 30 Days of a Hospital Admission

2015 ◽  
Vol 16 (7) ◽  
pp. 1025-1029 ◽  
Author(s):  
Jesse Brennan ◽  
Theodore Chan ◽  
James Killeen ◽  
Edward Castillo
Keyword(s):  
Emergency Department ◽  
Hospital Admission ◽  
Emergency Department Visits

scholarly journals National Trends in Leukemia Related Emergency Department Visits, Health Care Burden and Disposition Rate in the United States, 2010-2014

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4695-4695
Author(s):  
Mohamed Mokhtar Bakr ◽  
Umar Zahid ◽  
Pavan Tenneti ◽  
Alsadiq Waleed Al-Hillan ◽  
Faiz Anwer
Keyword(s):  
United States ◽  
Health Care ◽  
Emergency Department ◽  
Hospital Admission ◽  
The United States ◽  
Emergency Department Visits ◽  
P Value ◽  
Health Care Burden ◽  
Ed Visits ◽  
National Trends

Abstract National Trends in Leukemia Related Emergency Department Visits, Health Care Burden and Disposition Rate in the United States, 2010-2014. Background: Recently emergency department (ED) utilization has been increasing for the management of acute conditions. Utilization of ED healthcare services by hematology and oncology patients have been documented previously. Cancer patients frequently visit the EDs with acute symptoms, that may require further assessment, management, and even hospitalization. Whether the incidence of leukemia related ED visits has altered is unknown. The aim of this study was to analyze the trend of leukemia related ED visits, healthcare cost associated with the visit and the discharge disposition from ED. Methods: We utilized Nationwide Emergency Department Sample (NEDS) dataset for this study. NEDS is a part of the Healthcare Cost and Utilization Project (HCUP) database and contains the information of more than 950 United States (US) hospitals that is weighted to the national estimates. We used five years of data from 2010 to 2014 to examine the trends in prevalence and rates of ED visits, cost, and disposition (such as admission, discharge and death in ED). We defined patients with leukemia (acute myeloid, chronic myeloid, acute lymphocytic, and chronic lymphocytic leukemias) by using the international classification of disease, 9th revision, clinical modification (ICD-9-CM) codes. Cochrane-Armitage test was used to assess the trend of leukemia ER visits over five years. We used estimated US census population to calculate the rate of leukemia related ED visits. Furthermore, we assessed the predictors of hospital admission by using multivariable logistic regression model. Results: Between 2010 to 2014, a nationally weighted estimate of 771,510 patients visited ED with leukemia. The frequency of leukemia related ED visits increased 21.7% from 138,038 to 167,935 during this period that accounted for 0.12% of all ED visits. The rate of leukemia related ED visits increased 20.5% from 44 to 53 per 100,000 census population, which was statistically significant (p=0.04) on a trend test. The total national cost of leukemia related visit increased by 81% from $544 million in 2010 to $984 million in 2014 (p-value<0.001). While the mean cost of each leukemia related ED visit increased 50.7% from $2367 in 2010 to $3566 in 2014 (p-value <0.001). Rate of discharge to home from ED for leukemia related visits increased 31.6% (from 22.88% in 2010 to 30.12% in 2014) (p<0.05). Similarly, the rate of in hospital admission decreased 9% from 2010 to 2014. The rate of death in a leukemia related visit remained same (0.17%) from 2010 to 2013 but in 2014 death rate increased from 0.17% to 0.23% (p-value >0.05). In an adjusted multivariable logistic regression analysis, increasing age (OR 1.02 95% CI 1.024, 1.027), male gender (OR 1.15, 95% CI 1.114, 1.188), patient location in metropolitan area (OR 2.08, 95% CI 1.88, 2.22) and northeast location (OR 1.16, 95% CI 1.03, 1.32) were found to be significantly associated with the higher odds of in hospital admission following leukemia related ED visits. While few other variables like residents of higher income quartile and those holding Medicaid, insurance were also found to be positively associated with the hospitalization but were not statistically significant (OR>1.00, p>0.05). Conclusions: There is an increasing trend of leukemia related ED utilization and associated total and mean/median costs over time, while the rate of hospitalization for leukemia associated visit from ED have decreased. Oncology providers need to plan care accordingly to reduce ER visits and hospital admission for patients with leukemia. Disclosures No relevant conflicts of interest to declare.

Complications following prostate needle biopsy requiring hospital admission or emergency department visits - experience from 1000 consecutive cases

2012 ◽  
Vol 110 (3) ◽  
pp. 369-374 ◽  
Author(s):  
G. Igor Pinkhasov ◽  
Yu-Kuan Lin ◽  
Ricardo Palmerola ◽  
Paul Smith ◽  
Frank Mahon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hospital Admission ◽  
Needle Biopsy ◽  
Emergency Department Visits ◽  
Prostate Needle Biopsy
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