Recently diagnosed cancer patients often decide on their own to visit hospital emergency departments (EDs) for symptoms that don’t warrant that type of care, UT Southwestern Medical Center researchers report. Their study's results, published in the American Journal of Managed Care, could help patients safely avoid going to the ED.
Researchers evaluated data from the tumor registries of UT Southwestern and Parkland Health, a public safety-net health system for the uninsured that serves as the primary teaching hospital for UTSW. The researchers identified 39,498 adults with a new cancer diagnosis between 2012 and 2018, then compared records from these patients to those in a database of ED visits within six months of diagnosis. That database is maintained by the Dallas-Fort Worth Hospital Council Foundation, which keeps records of 12 million patients within a 100-mile radius of Dallas including details of their hospital visits.
Just over 40% of the patients made no ED visits in the six months after their diagnoses, but about 50% made one to three, and nearly 10% had four or more. Of patients who made ED visits, about 81% always self-referred, about 7% relied on medical advice at least once, and about 12% always called for triage help before an ED visit.
Although more than half of these visits ended in hospitalizations and a quarter were classified as emergencies but didn’t require hospitalization, another quarter did not require emergency care. These nonemergency visits were more likely for patients who did not consult a nurse triage line, went to the ED on weekends or holidays, or went to EDs closer to their home.
Patients who visited EDs bypassed an average of 13 that were closer to their homes. Those who visited closer EDs were no more likely to be experiencing a true medical emergency than those who traveled farther.
About half of ED visits were to centers not associated with the patient’s cancer care.