ED use for patients with cancer likely reflects a complex interaction of individual and contextual factors-including provider behavior, health system characteristics, and health policies-that warrants greater attention in the literature. Similar patterns of cancer-related ED use are observed internationally across a range of different national payment and health system settings. Approximately 44% of cancer patients visit the ED within 1 year of diagnosis, and more often have repeat ED visits within a short time frame, though there is substantial variability across cancer types. The most recent population-based estimates suggest 4% of all ED visits are cancer-related and roughly two thirds of these ED visits result in hospitalization-a 4-fold higher ED hospitalization rate than the general population. This article describes the characteristics and determinants of ED visits, as well as challenges in the effort to define preventable ED visits in this population. Patients with cancer present to the ED across the cancer care continuum from diagnosis through treatment, survivorship, and end-of-life. There is an argument that had a doctor with gerontological expertise been able to start intravenous antibiotics in the nursing home seen that patient seven days’ previously, it was likely that they would not be presenting in the ED as sick as they did, he added.The global prevalence of cancer is rapidly increasing and will increase the acute care needs of patients with cancer, including emergency department (ED) care. Dr Kennelly said this significantly increased their risk of dying within five months. The research, which was presented at the recent annual meeting of the Irish Gerontological Society in UCC, also revealed that 36 per cent of elderly patients attending the ED had Systemic Inflammatory Response Syndrome (SIRS), a marker of severity of infection, which showed they were suffering from sepsis.
#Preventable ed visits how to
“You can really only in all honesty discuss potentially preventable when you make sure that there is adequate community palliative care, community geriatrician input and nurses are trained in how to administer IV antibiotics.” “They are preventable within the context that you have established all of those community-based services that are necessary to look after what is a very, very frail and complex group of patients,” he said. Speaking to Irish Medical Times, one of the authors of the study, Dr Sean Kennelly, Consultant Geriatrician at Tallaght Hospital, said that while more than a half (55 per cent) of ED attendances could have been avoided, this would only be possible if appropriate community supports were available. It also found that almost half, or 43 per cent of patients, had been reviewed in the ED in the previous 12 months, 28 per cent had been seen in the previous six months, and 19 per cent died within five months of attending the ED. Carried out over an 18-week period in 2011, the study further revealed that the most frequent reasons for ED referral were a urinary tract infection, pneumonia and falls or falls-related injuries, and 34 per cent of patients attended the ED more than once over the 18 weeks.
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