12/5/2023 0 Comments Best care for follow ed visits![]() The results of these efforts have been mixed. Initiatives, such as the Centers for Medicare & Medicaid Services Oncology Care Model, encourage innovation to improve quality of care and reduce Medicare spending through financial incentives. Clinicians and researchers continue to develop and test assessment tools that identify patients at greater risk for high care needs and strategies to provide support that minimizes the need for urgent and emergency care. ĭue to varying levels of oncology care model implementation, resource availability, and the complexity of cancer treatment, patients experiencing acute complications (e.g., fever, shortness of breath) rely on urgent and emergency care providers to efficiently triage and stabilize medical presentations and coordinate follow-up care with oncology care teams. Retrospective studies of US emergency department (ED) visits by patients presenting with a cancer-related complaint report 4.2 million adult and nearly 300,000 pediatric visits annually. ![]() This often results in patients and caregivers seeking care outside of their oncology team. Managing unexpected or acute side effects and adverse events from cancer and cancer therapy poses a challenge to ambulatory care patients, their caregivers, and the healthcare system. However, critical gaps remain.Īn estimated 1.9 million new cancer diagnoses were made in the United States (US) during 2021, with increasing frequency of treatment provided in the outpatient setting. Significant progress has been made over the past 7 years with the creation of the Comprehensive Oncologic Emergency Research Network, broad involvement of the emergency medicine and oncology communities, establishing a proof-of-concept observational study, and NCI and OECR’s efforts to support this area of research. Opportunities included better characterizing unscheduled care services, identifying those at higher risk for such care, developing care delivery models to minimize unplanned events and enhance their care, recognizing cancer prevention and screening opportunities in the ED, improving management of specific cancer-related presentations, and conducting goals of care conversations. Workshop participants recommended a number of promising research opportunities, as well as key considerations for designing and conducting research in this area. Since 2014, NCI and OECR have collaborated to support research in cancer-related emergency care. This report describes the current landscape of cancer-related urgent and emergency care and includes research recommendations from workshop participants to decrease the risk of oncologic complications, improve their management, and enhance coordination of care. The National Cancer Institute (NCI) and the Office of Emergency Care (OECR) convened a workshop in December 2021, “Cancer-related Emergency and Urgent Care: Prevention, Management, and Care Coordination” to highlight progress, knowledge gaps, and research opportunities. Implementing effective approaches across different care settings and populations to minimize ED and urgent care visits improves oncologic complication management, and coordinating follow-up care will be particularly important as the population of cancer patients and survivors continues to increase. ![]() It has been estimated many of these costly hospital admissions can be prevented, yet urgent care clinics and EDs lack cancer-specific care resources to support the needs of this complex population. Cancer-related emergency department (ED) visits often result in higher hospital admission rates than non-cancer visits.
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