Chemotherapy outpatients’ unplanned presentations to hospital: a retrospective study

McKenzie, Heather; Hayes, Lillian; White, Kathryn; Cox, Kimberly; Fethney, Judith; Boughton, Maureen; Dunn, Jo

doi:10.1007/s00520-010-0913-y

Cited by 141 publications

(137 citation statements)

References 26 publications

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“…Study participants reported four primary gaps in cancer care delivery, including poor doctor-patient communication, insufficient attention to conversations about prognosis, lack of care coordination, and lack of access to care locations. Despite efforts to improve patient-provider communication regarding goals of care and symptom management, 8,9,[24][25][26][27] patients and caregivers noted persistent deficiencies, 7,28,29 consistent with previous studies. 2,5,10,11 Study participants identified three practical solutions to reduce these care gaps, including use of (1) nonphysician health personnel (eg, community health workers, patient navigators); (2) alternative care formats (eg, telephone-based care); and (3) extending community-based care locations (eg, home visits, chemotherapy delivery).…”

Section: Discussionsupporting

confidence: 80%

Redesigning Cancer Care Delivery: Views From Patients and Caregivers

Patel

Periyakoil

Blayney

et al. 2017

JOP

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Introduction: Cancer is a leading cause of death in the United States. Although treatments have improved, patients and caregivers continue to report significant gaps in their care. The objective of this study was to examine the views of patients and caregivers on their experiences with current cancer care delivery and identify key strategies to improve the delivery of care. Methods and Materials: Semistructured interviews were conducted with 75 patients and 45 caregivers across the United States. The interviews were recorded, transcribed, and analyzed using constant comparative method of qualitative analysis. Results: Participants reported multiple gaps in care delivery, including barriers in health communication with health care providers, lack of elucidation of care goals, lack of care coordination, and challenges in accessing care. Participants identified that greater use of nonphysician providers and alternative formats, such as telephone-based care and home and community-based care, would narrow these gaps. Conclusion: Understanding patients’ and caregivers’ experiences with gaps in cancer care delivery can inform cancer care delivery redesign efforts and lead to targeted interventions that result in patient-centered and family-oriented care.

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Section: Discussionsupporting

confidence: 80%

Redesigning Cancer Care Delivery: Views From Patients and Caregivers

Patel

Periyakoil

Blayney

et al. 2017

JOP

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“…Unplanned presentations and admissions for cancer patients are common and cause congestion and delays for other patients requiring scheduled treatments [1]. They have a negative impact on patients and carers and put undue strain on health care resources and expenditure [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Unplanned oncology admissions within 14 days of non-surgical discharge: a retrospective study

Gibson

McConigley

2015

Support Care Cancer

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“…22, 23 Through characterization of potentially avoidable hospitalizations in patients with cancer, we sought to establish a conceptual framework for the study of potentially avoidable oncology hospitalizations and to enhance the knowledge base that informs the design of future interventions.…”

Section: Journal Of Clinical Oncology O R I G I N a L R E P O R T V Omentioning

confidence: 99%

Identification of Potentially Avoidable Hospitalizations in Patients With GI Cancer

Brooks

Abrams

Meyerhardt

et al. 2014

JCO

129

110

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Purpose To identify and characterize potentially avoidable hospitalizations in patients with GI malignancies. Patients and Methods We compiled a retrospective series of sequential hospital admissions in patients with GI cancer. Patients were admitted to an inpatient medical oncology or palliative care service between December 2011 and July 2012. Practicing oncology clinicians used a consensus-driven medical record review process to categorize each hospitalization as “potentially avoidable” or “not avoidable.” Patient demographic and clinical data were abstracted, and quantitative and qualitative analyses were performed to identify patient characteristics and outcomes associated with potentially avoidable hospitalizations. Results We evaluated 201 hospitalizations in 154 unique patients. The median age was 62 years, and colorectal cancer was the most common diagnosis (32%). The majority of hospitalized patients had metastatic cancer (81%). In all, 53% of hospitalizations were attributable to cancer symptoms, and 28% were attributable to complications of cancer treatment. Medical oncologists identified 39 hospitalizations (19%) as potentially avoidable. Hospitalizations were more likely to be categorized as potentially avoidable for patients with the following characteristics: age ≥ 70 years (odds ratio [OR], 2.63; 95% CI, 1.15 to 6.02), receipt of an oncologist's advice to consider hospice (OR, 6.09; 95% CI, 2.54 to 14.58), or receipt of three or more lines of chemotherapy (OR, 2.68; 95% CI, 1.01 to 7.08). Ninety-day mortality was higher after avoidable hospitalizations compared with hospitalizations that were not avoidable (OR, 6.4; 95% CI, 1.8 to 22.3). Conclusion Potentially avoidable hospitalizations are common in patients with advanced GI cancer. The majority of potentially avoidable hospitalizations occurred in patients with advanced treatment-refractory cancers near the end of life.

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Chemotherapy outpatients’ unplanned presentations to hospital: a retrospective study

Abstract: Chemotherapy outpatients have significant unmet needs following treatment, indicating an urgent need for improved continuity of care and better integration of primary and tertiary health care services.

Cited by 141 publications

References 26 publications

Redesigning Cancer Care Delivery: Views From Patients and Caregivers

Redesigning Cancer Care Delivery: Views From Patients and Caregivers

Unplanned oncology admissions within 14 days of non-surgical discharge: a retrospective study

Identification of Potentially Avoidable Hospitalizations in Patients With GI Cancer

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