Impact of Establishment of Cancer Urgent Care Clinic on Emergency Department Visits
In a study reported in the Journal of Oncology Practice, Hong et al found that the establishment of a cancer urgent care clinic slowed the increasing rate of visits to regional emergency departments among adults newly diagnosed with cancer.
Study Details
The study involved data on 33,316 patients diagnosed with cancer between 2009 and 2016 at a comprehensive cancer center. Patients were linked to a longitudinal regional database of emergency department and hospital visits. Trends in regional emergency department visits were analyzed before and after establishment of the cancer urgent care clinic in May 2012. The primary outcome measure was emergency department visits within 180 days after cancer diagnosis expressed as adjusted monthly rates of emergency department visits per 1,000 patient-months.
Effect of Intervention
The rate of weekday emergency department visits was increasing at a rate of 0.43 visits per month prior to May 2012; after the cancer urgent care clinic was established, the rate of increase declined to 0.19 visits per month (P = .007). The urgent care clinic was closed on weekends; the weekend visit rate grew at a rate of 0.08 visits per month before May 2012 and at 0.05 visits per month after May 2012 (P = .533). During the postintervention period, 4,846 patients had ≥ 1 emergency department visit within the 180 days after their cancer diagnosis, among these, 589 patients (12.2%) completed 861 urgent care clinic visits during the same period. By the end of 2016, there were 15.3 fewer monthly weekday emergency department visits than projected (P = .005). No differences in trends in weekday visits resulting in hospitalization were observed.
The investigators concluded, “Although only one in eight emergency department–visiting patients also used the urgent care clinic, the growth rate of emergency department visits fell by half after the urgent care clinic was established.”
Arthur S. Hong, MD, MPH, of the University of Texas Southwestern Medical Center, is the corresponding author for the Journal of Oncology Practice article.
Disclosure: The study was supported by the Texas Health Resources Clinical Scholars Program, the National Center for Advancing Translational Sciences of the National Institutes of Health, the Agency for Healthcare Research and Quality, and the National Cancer Institute. For full disclosures of the study authors, visit jop.ascopubs.org.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
