A Systematic Review of Emergency Department Use Among Cancer Patients
Rebecca S Lash1, Janice F Bell, Sarah C Reed
1Author Affiliations: Collaborative Cancer Care Research Group (3CRG), Betty Irene Moore School of Nursing, University of California, Davis, Sacramento (Drs Lash, Bell, Kim, Bold, and Joseph; Ms Reed; and Mr Rodgers); Department of Nursing Research and Education, UCLA Health (Dr Lash); and College of Nursing and Health Sciences University of Massachusetts, Boston (Dr Poghosyan).
Cancer Nursing
|March 2, 2016
Summary
Oncology patients visit the emergency department (ED) more often than the general population. Better symptom management and care coordination can help reduce potentially avoidable ED visits for cancer patients.
Area of Science:
- Oncology
- Health Services Research
- Emergency Medicine
Background:
- Emergency department (ED) visits for oncology patients present challenges due to patient diversity and unpredictable clinical environments.
- While ED use is appropriate for acute oncology concerns, some visits may be preventable.
- Reducing costly and avoidable healthcare services, such as ED visits, is a growing concern.
Purpose of the Study:
- To systematically review the existing literature on the incidence, predictors, and reasons for emergency department (ED) visits among oncology patients.
- To synthesize evidence on the frequency and contributing factors of ED utilization in cancer care.
Main Methods:
- Conducted comprehensive literature searches across four online databases.
- Included studies published between April 2003 and December 2014 with a minimum sample size of 50.
- Focused on studies reporting the incidence or predictors of ED use in oncology patients.
Main Results:
- Fifteen studies met the inclusion criteria, exhibiting diverse aims, designs, and time frames.
- The incidence of ED visits among oncology patients varied widely, ranging from 1% to 83%.
- The 30-day standardized visit rate incidence ranged from 1% to 12%, with a lack of population-based estimates for all cancers combined.
Conclusions:
- Evidence suggests oncology patients utilize emergency departments (EDs) at higher rates than the general population.
- The precise extent of ED use and the specific reasons for these visits among cancer patients require further investigation.
- Nurses are pivotal in developing patient-centered care coordination plans to enhance quality and decrease ED visits.
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