July 8, 2019

Cancer patients keep winding up in the ED. Should they have their own urgent care centers instead?

Daily Briefing

    Urgent care centers specifically designed for patients with cancer might reduce patients' ED utilization in the first six months of diagnosis, helping them avoid the risks associated with a hospital visit and lowering the overall cost of care, according to a study recently published in the Journal of Oncology Practice.

    The birth of the cancer urgent care center

    Adult cancer patients typically generate a high volume of unplanned ED visits for pain, nausea, and other issues during the first six months of their diagnosis, Christopher Cheney reports for HealthLeaders Media. In many of these cases, patients are hospitalized, which can disrupt their daily schedule and expose them to the risks of a hospital stay, Cheney reports. The visits also increase cancer care expenditures.

    In an effort to improve care for cancer patients, a small number of hospitals, including University of Texas (UT) Southwestern Medical Center, have launched cancer-specific urgent care centers, according to Arthur Hong, lead author of the study and an assistant professor of internal medicine and clinical sciences at UT Southwestern.  

    For the study, Hong and his colleagues sought to determine whether UT Southwestern's cancer-specific urgent care center, which launched in 2012, helped to reduced ED visits among 33,000 adult cancer patients who were diagnosed with cancer at a comprehensive cancer center between 2009 and 2016. The researchers looked at visits within 180 days of diagnosis.

    Key findings

    The researchers found that after the urgent care center opened, weekday ED visits among cancer patients dropped from 0.43 visits per 1,000 patient-months to 0.19 visits per 1,000 patient-months.

    The researchers noted that while there was a drop in ED visits among cancer patients on weekdays, when the urgent care center was open, the trend did not hold true on weekends, when the urgent care center was closed. "This increases our confidence that the urgent care clinic was associated with a real reduction in ED visits when the clinic was open," the researchers wrote.

    Discussion

    "What patients really want is a trusted resource and an alternative to the ED because—anywhere you go in the country—there are untold hours you could wait at an ED," Hong said. "Patients also may be worried about being exposed to the dangerous infections that people have in an ED. An urgent care center checks off a lot of boxes in terms of what cancer patients are looking for."

    For health systems that are thinking of launching a cancer urgent care, Hong said leaders should assess their patient population to see which services would be most helpful in an urgent care setting (Cheney, HealthLeaders Media, 7/1; Hong et al., PubMed.gov, accessed 7/3).

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