Back to Search
Start Over
The Impact on Resource Utilization of Supportive Care Consults on Patients at the University of North Carolina Hospital, 2010-2012
- Source :
- Journal of palliative medicine. 21(2)
- Publication Year :
- 2017
-
Abstract
- Cancer patients have a high rate of emergency department (ED) visits and inpatient hospitalizations (IHs) that may be reduced by use of outpatient palliative care services.To determine whether the outpatient adult palliative care service at the University of North Carolina (UNC) Hospital, begun in 2008, reduced the frequency of ED visits and IH during a two-year period.The charts of patients with lung cancer or head and neck cancer seen by the supportive care service from 2010 to 2011, and of a contemporaneous set of potential consults that were not seen, were retrospectively reviewed to determine the impact of this care delivery model.The number of individuals with lung cancer and head cancer seen during this two-year period was 24 and 23, respectively, permitting a statistical analysis from which meaningful conclusions could be drawn.The frequency of ED visits and IHs for each patient was reviewed. Descriptive statistics were used. Fisher's exact test was used for data categorized into two by two contingency tables. The nonparametric Jonckheere-Terpstra method was used to test for ordered differences across categories.Consultation with supportive care did not decrease overall use of ED visits. Patients with head and neck cancer showed an increase in ED visits (p = 0.08) but a reduction in inpatient admissions (p = 0.0004). In patients with lung cancer, the opposite effect was seen-an increase in inpatient visits (p = 0.02) but a decrease in ED visits. The frequency of ED visits was correlated with distance to the ED (p = 0.02), a finding that has not been noted before.Further work is needed to define the best model for outpatient palliative care.
- Subjects :
- Male
medicine.medical_specialty
Palliative care
Lung Neoplasms
03 medical and health sciences
0302 clinical medicine
medicine
Ambulatory Care
North Carolina
Humans
030212 general & internal medicine
Lung cancer
Referral and Consultation
General Nursing
Aged
Retrospective Studies
Descriptive statistics
business.industry
Head and neck cancer
Palliative Care
Cancer
General Medicine
Emergency department
Middle Aged
medicine.disease
Hospitalization
Anesthesiology and Pain Medicine
Head and Neck Neoplasms
030220 oncology & carcinogenesis
Emergency medicine
Head Cancer
Female
business
Emergency Service, Hospital
Resource utilization
Subjects
Details
- ISSN :
- 15577740
- Volume :
- 21
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Journal of palliative medicine
- Accession number :
- edsair.doi.dedup.....2be9f8684e7b7a262d1deaad656e0be3