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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
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Frequent Emergency Department Utilizers Among Children with Cancer

Emily L Mueller1,2, Matt Hall3, Aaron E Carroll2,4

  • 1Section of Pediatric Hematology Oncology, Department of Pediatrics, Indiana University, Indianapolis, Indiana.

Pediatric Blood & Cancer
|February 4, 2016
PubMed

Insights

Frequent emergency department (ED) use is common in children with cancer, with a small group accounting for most visits. Future research should focus on these frequent pediatric cancer patient ED users.

Area of Science:

  • Pediatric Oncology
  • Healthcare Services Research
  • Emergency Medicine

Background:

  • Pediatric frequent emergency department (ED) utilizers represent a significant burden on healthcare resources.
  • No prior studies have specifically investigated frequent ED utilization patterns in children with cancer.

Purpose of the Study:

  • To identify the characteristics and factors associated with frequent ED utilization among pediatric cancer patients.
  • To understand the patterns of care received during ED visits by children with cancer.

Main Methods:

  • Retrospective analysis of the Pediatric Health Information System database for ED visits in children with a malignancy diagnosis.
  • Definition of frequent ED utilizers as those with >= 4 visits within 365 days of initial inpatient encounter (top 10th percentile).
  • Multivariable regression analysis to identify factors associated with frequent ED utilization and assessment of ED services provided.

Main Results:

  • Frequent ED utilizers accounted for 58% of all ED visits among children with cancer.
  • Frequent utilization was associated with specific cancer types (acute lymphoblastic leukemia, central nervous system tumors), younger age groups (<10 years), and Hispanic ethnicity.
  • A small proportion of children with cancer received no medication, laboratory, or imaging during their ED visits (11.0% for frequent vs. 12.5% for infrequent).

Conclusions:

  • The emergency department (ED) plays a crucial role in the care continuum for pediatric cancer patients.
  • Identifying and focusing on the subset of frequent ED utilizers is essential for future research and quality improvement initiatives in pediatric oncology care.
Abstract

Keywords:
adolescentchildoncologysupportive care

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