A Supportive Care in Cancer Unit Reduces Costs and Hospitalizations for Transfusions in a Comprehensive Cancer Center

2017 ◽  
Vol 103 (5) ◽  
pp. 449-456 ◽  
Author(s):  
Carla Ida Ripamonti ◽  
Pietro Molani ◽  
Cinzia Desti ◽  
Giacomo Boscagli ◽  
Fernando Ravagnani ◽  
...  
Keyword(s):  
Supportive Care ◽  
Blood Product ◽  
Hematologic Malignancies ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Daily Cost ◽  
Previous Hospitalization ◽  
Unplanned Hospitalizations ◽  
Outpatient Supportive Care ◽  
Average Daily Cost

Purpose Among patients with solid or hematologic malignancies undergoing oncologic therapies, blood product transfusions (BPT) are a relevant reason for planned/unplanned hospitalizations, as well as a possible cause of delay in administration of the oncologic therapies. Furthermore, they create additional costs for the healthcare system (HCS). The aim of this study was to compare the costs of performing BPT (erythrocytes and platelets) in medical units/wards to the costs derived from the administration of BPT in a dedicated outpatient supportive care in cancer unit (SCCU). Methods Costs were analyzed from June 3, 2009 (when the SCCU started), until December 2013. Four inpatient oncologic units (bone marrow transplantation, radiotherapy, medical oncology I and II) were compared to the SCCU. Data regarding the transfusions performed by the SCCU of the patients who were previously hospitalized for transfusions were extracted, checked, and analyzed through a cross-check on the tax codes. Therefore, patients were considered suitable for the analysis if they had received BPT in the SCCU after a previous hospitalization for transfusion in one of the 4 units/wards. The average daily cost deriving from blood product units and from the hospitalization in each ward (irrespective of pharmaceutical expenses) was compared with the average daily cost deriving from blood product units and from the management of patients in the SCCU. Results We analyzed 227 patients (112 female) with a mean age of 60 years (range 20-90) with hematologic malignancies in 79% of cases. The number of transfusions performed by the SCCU has grown constantly and consistently over the years, reaching 1,402 transfusions in 2013, thus exceeding the other considered units. The total savings for the HCS was €282.204.71, €151.182.85 in 2013 only. We saved €124.319,26 for each patient transfused at the SCCU. Conclusions A dedicated outpatient SCCU, aimed at monitoring and treating cancer therapy-related toxicities and comorbidities and in which it is also possible to perform BPT promptly and effectively, reduces the number of hospitalizations and provides an economical benefit for HCS.

Advanced cancer patients' (CP) attitudes and perceptions regarding reasons for outpatient supportive care (SC) referral at a comprehensive cancer center: A randomized controlled study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24135-e24135
Author(s):  
Angelique Wong ◽  
Frank V. Fossella ◽  
George R. Simon ◽  
Rama Maddi ◽  
Zhanni Lu ◽  
...  
Keyword(s):  
Supportive Care ◽  
Cancer Care ◽  
Comprehensive Cancer Center ◽  
Controlled Study ◽  
Cancer Center ◽  
Cancer Type ◽  
Attitudes And Perceptions ◽  
Outpatient Supportive Care

e24135 Background: Current ASCO guidelines propose early access to SC in all CP to improve quality of care, quality of life, and symptoms. Very few studies have evaluated patients’ perceived criteria for referral to outpatient SC and perceptions of patients who are referred early in their disease trajectory. Methods: In this study we evaluated CP attitudes and perceptions regarding the role of and access to outpatient Supportive Care clinic (SCC) at a comprehensive cancer center. CP with life expectancy of greater than 6 months (as determined by the oncologist) and who are newly registered at MD Anderson Cancer Center were randomized to either obtain an educational brochure that explained the role of the SCC or no brochure. Both groups then completed a survey regarding the role and access to of outpatient SCC. After completion of the survey, patients were asked if they would like to be seen by the SC team. If so, they were scheduled by their oncologist for a SC consult. Results: 288 patients were evaluable: median age was 63, 43% were female, 84% were Caucasian, and the most common cancer type was lung cancer (39%). Median survival was 15 months. Patients who received a brochure reported more understanding of the role of SC vs those who did not receive a brochure (63% vs 37%, p = 0.04). Both groups felt that SC could help to address physical (47% vs 54%) and psychosocial (50% vs 50%) symptoms. Both groups felt SC could help to address questions regarding prognosis (50% vs 50%) and future care (53% vs 47%). Both groups did not feel that time (50% vs 50%) nor financial concerns (49% vs 51%) would be barriers to access SC. Both groups did not feel that receiving SC would impede their cancer care (60% vs 40%) nor change their oncologists’ perspective of them (25% vs 75%). Both groups felt they could receive SC and cancer care simultaneously (50% vs 50%). Approximately half of the patients in both groups perceived it was not too early for a referral to SC. There were no statistical differences in these groups for these findings. Conclusions: Patients who received a brochure had a better understanding of the role of SC. A very significant proportion in both groups had limited awareness of the value of SC. Oncologist driven referral and education of SC may facilitate better understanding of the value of SC. Further studies are needed.

scholarly journals P135 Snapshot of an Outpatient Supportive Care Center at a Comprehensive Cancer Center

2016 ◽  
Vol 52 (6) ◽  
pp. e101
Author(s):  
Lindsey E. Pimentel ◽  
Maxine De la Cruz ◽  
Angelique Wong ◽  
Debra Castro ◽  
Eduardo Bruera
Keyword(s):  
Supportive Care ◽  
Care Center ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Outpatient Supportive Care

Predicting the risk for aberrant opioid use behavior in patients receiving outpatient supportive care consultation at a comprehensive cancer center

Cancer ◽  
2018 ◽  
Vol 124 (19) ◽  
pp. 3942-3949 ◽  
Author(s):  
Sriram Yennurajalingam ◽  
Tonya Edwards ◽  
Joseph A. Arthur ◽  
Zhanni Lu ◽  
John Najera ◽  
...  
Keyword(s):  
Supportive Care ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Opioid Use ◽  
Care Consultation ◽  
Use Behavior ◽  
Outpatient Supportive Care

Snapshot of an Outpatient Supportive Care Center at a Comprehensive Cancer Center

2017 ◽  
Vol 20 (4) ◽  
pp. 433-436 ◽  
Author(s):  
Lindsey E. Pimentel ◽  
Maxine De La Cruz ◽  
Angelique Wong ◽  
Debra Castro ◽  
Eduardo Bruera
Keyword(s):  
Supportive Care ◽  
Care Center ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Outpatient Supportive Care

scholarly journals Active Mycobacterium tuberculosis infection at a comprehensive cancer center, 2006–2014

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Joumana Kmeid ◽  
Prathit A. Kulkarni ◽  
Marjorie V. Batista ◽  
Firas El Chaer ◽  
Amrita Prayag ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Cancer Patients ◽  
Hematopoietic Cell Transplantation ◽  
Average Rate ◽  
Hematologic Malignancies ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Mycobacterium Tuberculosis Infection ◽  
Patients With Cancer ◽  
Disseminated Disease

Abstract Background Morbidity and mortality from Mycobacterium tuberculosis (Mtb) infection remain significant in cancer patients. We evaluated clinical characteristics, management, and outcomes in patients with active Mtb infection at our institution who had cancer or suspicion of cancer. Methods We retrospectively examined medical records of all patients with laboratory-confirmed active Mtb infection diagnosed between 2006 and 2014. Results A total of 52 patients with laboratory-confirmed active Mtb infection were identified during the study period, resulting in an average rate of 6 new cases per year. Thirty-two (62%) patients had underlying cancer, while 20 (38%) patients did not have cancer but were referred to the institution because of suspicion of underlying malignancy. Among patients with cancer, 18 (56%) had solid tumors; 8 (25%) had active hematologic malignancies; and 6 (19%) had undergone hematopoietic-cell transplantation (HCT). Patients with and without cancer were overall similar with the exception of median age (61 years in cancer patients compared to 53 years in noncancer patients). Pulmonary disease was identified in 32 (62%) patients, extrapulmonary disease in 10 (19%) patients, and disseminated disease in 10 (19%) patients. Chemotherapy was delayed in 53% of patients who were to receive such treatment. Eleven patients (all of whom had cancer) died; 3 of these deaths were attributable to Mtb infection. Conclusions Although not common, tuberculosis remains an important infection in patients with cancer. Approximately one-third of patients were referred to our institution for suspicion of cancer but were ultimately diagnosed with active Mtb infection rather than malignancy.

Access to palliative care before death among patients treated at a comprehensive cancer center.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 25-25
Author(s):  
David Hui ◽  
Sun Hyun Kim ◽  
Jung Hye Kwon ◽  
Kimberson Cochien Tanco ◽  
Tao Zhang ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Disease Process ◽  
Hematologic Malignancies ◽  
Median Number ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Medical Team ◽  
Missed Opportunities

25 Background: Palliative care (PC) access is a critical component of quality cancer care. Previous studies on PC access have mostly examined the timing of PC referral. The proportion of patients who actually received PC is unclear. We determined the proportion of cancer patients who received PC at our comprehensive cancer center, and the predictors of PC referral. Methods: We reviewed the charts ofconsecutive patients with advanced cancer from the Houston region seen at MD Anderson Cancer Center and died between September 2009 and February 2010. We compared patients who received PC services with those who did not receive PC services before death using univariate and multivariate logistic regression. Results: A total of 366/816 (45%) decedents had a PC consultation. The median interval between PC consultation and death was 1.4 months (interquartile range (0.5-4.2) and the median number of medical team encounters before PC was 20 (6-45). In multivariate analysis, older age, being married, and specific cancer types (gynecology, lung and head and neck) were significantly associated with a PC referral (Table). Patients with hematologic malignancies had significantly fewer PC referrals (33%), the longest interval between advanced cancer diagnosis and PC consultation (median 16 months), the shortest interval between PC consultation and death (median 0.4 month), and one of the largest number of medical team encounters (median 38) before PC. Conclusions: We found that a majority of cancer patients at our cancer center did not access PC before they die. PC referral occurs late in the disease process with many missed opportunities for referral. Further effort is needed to improve quality of end-of-life care. [Table: see text]

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