Impact of an oncology urgent care center on preventable emergency department visits: revisiting lessons from a global pandemic to improve quality of care.
Oncologic urgent care centers (UCCs) have been shown to reduce emergency department (ED) visits. However, their impact on potentially preventable (PP) presentations, including those with diagnoses in CMS' OP-35 (OP-35) quality metric, has not been evaluated. This study assesses the impact of a specialty-specific UCC on PP ED visits in patients receiving chemotherapy.
In this retrospective, single-center analysis, patients were included if they received parenteral or oral chemotherapy within 30 days of ED presentation between March 2019 and June 2021. A UCC tailored toward managing patients with COVID-19 symptoms was opened between March 2020 and June 2021 (intervention period). Outcomes compared before and during the intervention period included weekly incidence of PP ED visits, defined as visits that would be captured in OP-35. Interrupted time series design was utilized.
A total of 2272 ED visits occurred in the study period. Most were for patients > 55 years old (n = 1706, 75%), female (n = 1227, 54%), and with gastrointestinal cancer (n = 637, 28%). Overall 928 (41%) ED visits during the study period were PP. There were 3.8 (95% CI, 0.6 to 7.0) PP weekly ED visits during the intervention period versus 11.0 (95% CI, 9.4 to 12.6) before the intervention period, reflecting a reduction in 7.2 weekly visits (95% CI, - 10.8 to - 3.6).
The opening of an oncologic UCC was associated with a reduction in PP ED visits. UCCs can be important in an oncologic service line to reduce unnecessary ED usage, but prospective evaluations are needed to confirm this finding.
In this retrospective, single-center analysis, patients were included if they received parenteral or oral chemotherapy within 30 days of ED presentation between March 2019 and June 2021. A UCC tailored toward managing patients with COVID-19 symptoms was opened between March 2020 and June 2021 (intervention period). Outcomes compared before and during the intervention period included weekly incidence of PP ED visits, defined as visits that would be captured in OP-35. Interrupted time series design was utilized.
A total of 2272 ED visits occurred in the study period. Most were for patients > 55 years old (n = 1706, 75%), female (n = 1227, 54%), and with gastrointestinal cancer (n = 637, 28%). Overall 928 (41%) ED visits during the study period were PP. There were 3.8 (95% CI, 0.6 to 7.0) PP weekly ED visits during the intervention period versus 11.0 (95% CI, 9.4 to 12.6) before the intervention period, reflecting a reduction in 7.2 weekly visits (95% CI, - 10.8 to - 3.6).
The opening of an oncologic UCC was associated with a reduction in PP ED visits. UCCs can be important in an oncologic service line to reduce unnecessary ED usage, but prospective evaluations are needed to confirm this finding.
Authors
Russell Russell, O'Donoghue O'Donoghue, Dechen Dechen, Lee Lee, Peters Peters, Sato-DiLorenzo Sato-DiLorenzo, Shea Shea, Weinstock Weinstock, Stevens Stevens, Zerillo Zerillo
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