Predictors of frequent emergency department visits among hospitalized cancer patients: a comparative cohort study using integrated clinical and administrative data to improve care delivery

Background Frequent emergency department (FED) visits by cancer patients represent a significant burden to the health system. This study identified determinants of FED in recently hospitalized cancer patients, with a particular focus on opioid use. Methods A prospective cohort discharged from surgic...
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Autor*in:	Kurteva, Siyana [verfasserIn] Tamblyn, Robyn Meguerditchian, Ari N.

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Emergency department visits Cancer Cohort study Frequent users

Anmerkung:	© The Author(s) 2023

Übergeordnetes Werk:	Enthalten in: BMC health services research - London : BioMed Central, 2001, 23(2023), 1 vom: 22. Aug.
Übergeordnetes Werk:	volume:23 ; year:2023 ; number:1 ; day:22 ; month:08

Links:	Volltext

DOI / URN:	10.1186/s12913-023-09854-1

Katalog-ID:	SPR052830519

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520			\|a Background Frequent emergency department (FED) visits by cancer patients represent a significant burden to the health system. This study identified determinants of FED in recently hospitalized cancer patients, with a particular focus on opioid use. Methods A prospective cohort discharged from surgical/medical units of the McGill University Health Centre was assembled. The outcome was FED use (≥ 4 ED visits) within one year of discharge. Data retrieved from the universal health insurance system was analyzed using Cox Proportional Hazards (PH) model, adopting the Lunn-McNeil approach for competing risk of death. Results Of 1253 patients, 14.5% became FED users. FED use was associated with chemotherapy one-year pre-admission (adjusted hazard ratio (aHR) 2.60, 95% CI: 1.80–3.70), ≥1 ED visit in the previous year (aHR: 1.80, 95% CI 1.20–2.80), ≥15 pre-admission ambulatory visits (aHR 1.54, 95% CI 1.06–2.34), previous opioid and benzodiazepine use (aHR: 1.40, 95% CI: 1.10–1.90 and aHR: 1.70, 95% CI: 1.10–2.40), Charlson Comorbidity Index ≥ 3 (aHR: 2.0, 95% CI: 1.2–3.4), diabetes (aHR: 1.60, 95% CI: 1.10–2.20), heart disease (aHR: 1.50, 95% CI: 1.10–2.20) and lung cancer (aHR: 1.70, 95% CI: 1.10–2.40). Surgery (cardiac (aHR: 0.33, 95% CI: 0.16–0.66), gastrointestinal (aHR: 0.34, 95% CI: 0.14–0.82) and thoracic (aHR: 0.45, 95% CI: 0.30–0.67) led to a decreased risk of FED use. Conclusions Cancer patients with higher co-morbidity, frequent use of the healthcare system, and opioid use were at increased risk of FED use. High-risk patients should be flagged for preventive intervention.
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allfields	10.1186/s12913-023-09854-1 doi (DE-627)SPR052830519 (SPR)s12913-023-09854-1-e DE-627 ger DE-627 rakwb eng Kurteva, Siyana verfasserin aut Predictors of frequent emergency department visits among hospitalized cancer patients: a comparative cohort study using integrated clinical and administrative data to improve care delivery 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Frequent emergency department (FED) visits by cancer patients represent a significant burden to the health system. This study identified determinants of FED in recently hospitalized cancer patients, with a particular focus on opioid use. Methods A prospective cohort discharged from surgical/medical units of the McGill University Health Centre was assembled. The outcome was FED use (≥ 4 ED visits) within one year of discharge. Data retrieved from the universal health insurance system was analyzed using Cox Proportional Hazards (PH) model, adopting the Lunn-McNeil approach for competing risk of death. Results Of 1253 patients, 14.5% became FED users. FED use was associated with chemotherapy one-year pre-admission (adjusted hazard ratio (aHR) 2.60, 95% CI: 1.80–3.70), ≥1 ED visit in the previous year (aHR: 1.80, 95% CI 1.20–2.80), ≥15 pre-admission ambulatory visits (aHR 1.54, 95% CI 1.06–2.34), previous opioid and benzodiazepine use (aHR: 1.40, 95% CI: 1.10–1.90 and aHR: 1.70, 95% CI: 1.10–2.40), Charlson Comorbidity Index ≥ 3 (aHR: 2.0, 95% CI: 1.2–3.4), diabetes (aHR: 1.60, 95% CI: 1.10–2.20), heart disease (aHR: 1.50, 95% CI: 1.10–2.20) and lung cancer (aHR: 1.70, 95% CI: 1.10–2.40). Surgery (cardiac (aHR: 0.33, 95% CI: 0.16–0.66), gastrointestinal (aHR: 0.34, 95% CI: 0.14–0.82) and thoracic (aHR: 0.45, 95% CI: 0.30–0.67) led to a decreased risk of FED use. Conclusions Cancer patients with higher co-morbidity, frequent use of the healthcare system, and opioid use were at increased risk of FED use. High-risk patients should be flagged for preventive intervention. Emergency department visits (dpeaa)DE-He213 Cancer (dpeaa)DE-He213 Cohort study (dpeaa)DE-He213 Frequent users (dpeaa)DE-He213 Tamblyn, Robyn aut Meguerditchian, Ari N. aut Enthalten in BMC health services research London : BioMed Central, 2001 23(2023), 1 vom: 22. Aug. (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:23 year:2023 number:1 day:22 month:08 https://dx.doi.org/10.1186/s12913-023-09854-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 23 2023 1 22 08
spelling	10.1186/s12913-023-09854-1 doi (DE-627)SPR052830519 (SPR)s12913-023-09854-1-e DE-627 ger DE-627 rakwb eng Kurteva, Siyana verfasserin aut Predictors of frequent emergency department visits among hospitalized cancer patients: a comparative cohort study using integrated clinical and administrative data to improve care delivery 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Frequent emergency department (FED) visits by cancer patients represent a significant burden to the health system. This study identified determinants of FED in recently hospitalized cancer patients, with a particular focus on opioid use. Methods A prospective cohort discharged from surgical/medical units of the McGill University Health Centre was assembled. The outcome was FED use (≥ 4 ED visits) within one year of discharge. Data retrieved from the universal health insurance system was analyzed using Cox Proportional Hazards (PH) model, adopting the Lunn-McNeil approach for competing risk of death. Results Of 1253 patients, 14.5% became FED users. FED use was associated with chemotherapy one-year pre-admission (adjusted hazard ratio (aHR) 2.60, 95% CI: 1.80–3.70), ≥1 ED visit in the previous year (aHR: 1.80, 95% CI 1.20–2.80), ≥15 pre-admission ambulatory visits (aHR 1.54, 95% CI 1.06–2.34), previous opioid and benzodiazepine use (aHR: 1.40, 95% CI: 1.10–1.90 and aHR: 1.70, 95% CI: 1.10–2.40), Charlson Comorbidity Index ≥ 3 (aHR: 2.0, 95% CI: 1.2–3.4), diabetes (aHR: 1.60, 95% CI: 1.10–2.20), heart disease (aHR: 1.50, 95% CI: 1.10–2.20) and lung cancer (aHR: 1.70, 95% CI: 1.10–2.40). Surgery (cardiac (aHR: 0.33, 95% CI: 0.16–0.66), gastrointestinal (aHR: 0.34, 95% CI: 0.14–0.82) and thoracic (aHR: 0.45, 95% CI: 0.30–0.67) led to a decreased risk of FED use. Conclusions Cancer patients with higher co-morbidity, frequent use of the healthcare system, and opioid use were at increased risk of FED use. High-risk patients should be flagged for preventive intervention. Emergency department visits (dpeaa)DE-He213 Cancer (dpeaa)DE-He213 Cohort study (dpeaa)DE-He213 Frequent users (dpeaa)DE-He213 Tamblyn, Robyn aut Meguerditchian, Ari N. aut Enthalten in BMC health services research London : BioMed Central, 2001 23(2023), 1 vom: 22. Aug. (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:23 year:2023 number:1 day:22 month:08 https://dx.doi.org/10.1186/s12913-023-09854-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 23 2023 1 22 08
allfields_unstemmed	10.1186/s12913-023-09854-1 doi (DE-627)SPR052830519 (SPR)s12913-023-09854-1-e DE-627 ger DE-627 rakwb eng Kurteva, Siyana verfasserin aut Predictors of frequent emergency department visits among hospitalized cancer patients: a comparative cohort study using integrated clinical and administrative data to improve care delivery 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Frequent emergency department (FED) visits by cancer patients represent a significant burden to the health system. This study identified determinants of FED in recently hospitalized cancer patients, with a particular focus on opioid use. Methods A prospective cohort discharged from surgical/medical units of the McGill University Health Centre was assembled. The outcome was FED use (≥ 4 ED visits) within one year of discharge. Data retrieved from the universal health insurance system was analyzed using Cox Proportional Hazards (PH) model, adopting the Lunn-McNeil approach for competing risk of death. Results Of 1253 patients, 14.5% became FED users. FED use was associated with chemotherapy one-year pre-admission (adjusted hazard ratio (aHR) 2.60, 95% CI: 1.80–3.70), ≥1 ED visit in the previous year (aHR: 1.80, 95% CI 1.20–2.80), ≥15 pre-admission ambulatory visits (aHR 1.54, 95% CI 1.06–2.34), previous opioid and benzodiazepine use (aHR: 1.40, 95% CI: 1.10–1.90 and aHR: 1.70, 95% CI: 1.10–2.40), Charlson Comorbidity Index ≥ 3 (aHR: 2.0, 95% CI: 1.2–3.4), diabetes (aHR: 1.60, 95% CI: 1.10–2.20), heart disease (aHR: 1.50, 95% CI: 1.10–2.20) and lung cancer (aHR: 1.70, 95% CI: 1.10–2.40). Surgery (cardiac (aHR: 0.33, 95% CI: 0.16–0.66), gastrointestinal (aHR: 0.34, 95% CI: 0.14–0.82) and thoracic (aHR: 0.45, 95% CI: 0.30–0.67) led to a decreased risk of FED use. Conclusions Cancer patients with higher co-morbidity, frequent use of the healthcare system, and opioid use were at increased risk of FED use. High-risk patients should be flagged for preventive intervention. Emergency department visits (dpeaa)DE-He213 Cancer (dpeaa)DE-He213 Cohort study (dpeaa)DE-He213 Frequent users (dpeaa)DE-He213 Tamblyn, Robyn aut Meguerditchian, Ari N. aut Enthalten in BMC health services research London : BioMed Central, 2001 23(2023), 1 vom: 22. Aug. (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:23 year:2023 number:1 day:22 month:08 https://dx.doi.org/10.1186/s12913-023-09854-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 23 2023 1 22 08
allfieldsGer	10.1186/s12913-023-09854-1 doi (DE-627)SPR052830519 (SPR)s12913-023-09854-1-e DE-627 ger DE-627 rakwb eng Kurteva, Siyana verfasserin aut Predictors of frequent emergency department visits among hospitalized cancer patients: a comparative cohort study using integrated clinical and administrative data to improve care delivery 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Frequent emergency department (FED) visits by cancer patients represent a significant burden to the health system. This study identified determinants of FED in recently hospitalized cancer patients, with a particular focus on opioid use. Methods A prospective cohort discharged from surgical/medical units of the McGill University Health Centre was assembled. The outcome was FED use (≥ 4 ED visits) within one year of discharge. Data retrieved from the universal health insurance system was analyzed using Cox Proportional Hazards (PH) model, adopting the Lunn-McNeil approach for competing risk of death. Results Of 1253 patients, 14.5% became FED users. FED use was associated with chemotherapy one-year pre-admission (adjusted hazard ratio (aHR) 2.60, 95% CI: 1.80–3.70), ≥1 ED visit in the previous year (aHR: 1.80, 95% CI 1.20–2.80), ≥15 pre-admission ambulatory visits (aHR 1.54, 95% CI 1.06–2.34), previous opioid and benzodiazepine use (aHR: 1.40, 95% CI: 1.10–1.90 and aHR: 1.70, 95% CI: 1.10–2.40), Charlson Comorbidity Index ≥ 3 (aHR: 2.0, 95% CI: 1.2–3.4), diabetes (aHR: 1.60, 95% CI: 1.10–2.20), heart disease (aHR: 1.50, 95% CI: 1.10–2.20) and lung cancer (aHR: 1.70, 95% CI: 1.10–2.40). Surgery (cardiac (aHR: 0.33, 95% CI: 0.16–0.66), gastrointestinal (aHR: 0.34, 95% CI: 0.14–0.82) and thoracic (aHR: 0.45, 95% CI: 0.30–0.67) led to a decreased risk of FED use. Conclusions Cancer patients with higher co-morbidity, frequent use of the healthcare system, and opioid use were at increased risk of FED use. High-risk patients should be flagged for preventive intervention. Emergency department visits (dpeaa)DE-He213 Cancer (dpeaa)DE-He213 Cohort study (dpeaa)DE-He213 Frequent users (dpeaa)DE-He213 Tamblyn, Robyn aut Meguerditchian, Ari N. aut Enthalten in BMC health services research London : BioMed Central, 2001 23(2023), 1 vom: 22. Aug. (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:23 year:2023 number:1 day:22 month:08 https://dx.doi.org/10.1186/s12913-023-09854-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 23 2023 1 22 08
allfieldsSound	10.1186/s12913-023-09854-1 doi (DE-627)SPR052830519 (SPR)s12913-023-09854-1-e DE-627 ger DE-627 rakwb eng Kurteva, Siyana verfasserin aut Predictors of frequent emergency department visits among hospitalized cancer patients: a comparative cohort study using integrated clinical and administrative data to improve care delivery 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background Frequent emergency department (FED) visits by cancer patients represent a significant burden to the health system. This study identified determinants of FED in recently hospitalized cancer patients, with a particular focus on opioid use. Methods A prospective cohort discharged from surgical/medical units of the McGill University Health Centre was assembled. The outcome was FED use (≥ 4 ED visits) within one year of discharge. Data retrieved from the universal health insurance system was analyzed using Cox Proportional Hazards (PH) model, adopting the Lunn-McNeil approach for competing risk of death. Results Of 1253 patients, 14.5% became FED users. FED use was associated with chemotherapy one-year pre-admission (adjusted hazard ratio (aHR) 2.60, 95% CI: 1.80–3.70), ≥1 ED visit in the previous year (aHR: 1.80, 95% CI 1.20–2.80), ≥15 pre-admission ambulatory visits (aHR 1.54, 95% CI 1.06–2.34), previous opioid and benzodiazepine use (aHR: 1.40, 95% CI: 1.10–1.90 and aHR: 1.70, 95% CI: 1.10–2.40), Charlson Comorbidity Index ≥ 3 (aHR: 2.0, 95% CI: 1.2–3.4), diabetes (aHR: 1.60, 95% CI: 1.10–2.20), heart disease (aHR: 1.50, 95% CI: 1.10–2.20) and lung cancer (aHR: 1.70, 95% CI: 1.10–2.40). Surgery (cardiac (aHR: 0.33, 95% CI: 0.16–0.66), gastrointestinal (aHR: 0.34, 95% CI: 0.14–0.82) and thoracic (aHR: 0.45, 95% CI: 0.30–0.67) led to a decreased risk of FED use. Conclusions Cancer patients with higher co-morbidity, frequent use of the healthcare system, and opioid use were at increased risk of FED use. High-risk patients should be flagged for preventive intervention. Emergency department visits (dpeaa)DE-He213 Cancer (dpeaa)DE-He213 Cohort study (dpeaa)DE-He213 Frequent users (dpeaa)DE-He213 Tamblyn, Robyn aut Meguerditchian, Ari N. aut Enthalten in BMC health services research London : BioMed Central, 2001 23(2023), 1 vom: 22. Aug. (DE-627)331018756 (DE-600)2050434-2 1472-6963 nnns volume:23 year:2023 number:1 day:22 month:08 https://dx.doi.org/10.1186/s12913-023-09854-1 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2129 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 23 2023 1 22 08
language	English
source	Enthalten in BMC health services research 23(2023), 1 vom: 22. Aug. volume:23 year:2023 number:1 day:22 month:08
sourceStr	Enthalten in BMC health services research 23(2023), 1 vom: 22. Aug. volume:23 year:2023 number:1 day:22 month:08
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Emergency department visits Cancer Cohort study Frequent users
isfreeaccess_bool	true
container_title	BMC health services research
authorswithroles_txt_mv	Kurteva, Siyana @@aut@@ Tamblyn, Robyn @@aut@@ Meguerditchian, Ari N. @@aut@@
publishDateDaySort_date	2023-08-22T00:00:00Z
hierarchy_top_id	331018756
id	SPR052830519
language_de	englisch
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This study identified determinants of FED in recently hospitalized cancer patients, with a particular focus on opioid use. Methods A prospective cohort discharged from surgical/medical units of the McGill University Health Centre was assembled. The outcome was FED use (≥ 4 ED visits) within one year of discharge. Data retrieved from the universal health insurance system was analyzed using Cox Proportional Hazards (PH) model, adopting the Lunn-McNeil approach for competing risk of death. Results Of 1253 patients, 14.5% became FED users. FED use was associated with chemotherapy one-year pre-admission (adjusted hazard ratio (aHR) 2.60, 95% CI: 1.80–3.70), ≥1 ED visit in the previous year (aHR: 1.80, 95% CI 1.20–2.80), ≥15 pre-admission ambulatory visits (aHR 1.54, 95% CI 1.06–2.34), previous opioid and benzodiazepine use (aHR: 1.40, 95% CI: 1.10–1.90 and aHR: 1.70, 95% CI: 1.10–2.40), Charlson Comorbidity Index ≥ 3 (aHR: 2.0, 95% CI: 1.2–3.4), diabetes (aHR: 1.60, 95% CI: 1.10–2.20), heart disease (aHR: 1.50, 95% CI: 1.10–2.20) and lung cancer (aHR: 1.70, 95% CI: 1.10–2.40). Surgery (cardiac (aHR: 0.33, 95% CI: 0.16–0.66), gastrointestinal (aHR: 0.34, 95% CI: 0.14–0.82) and thoracic (aHR: 0.45, 95% CI: 0.30–0.67) led to a decreased risk of FED use. Conclusions Cancer patients with higher co-morbidity, frequent use of the healthcare system, and opioid use were at increased risk of FED use. 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author	Kurteva, Siyana
spellingShingle	Kurteva, Siyana misc Emergency department visits misc Cancer misc Cohort study misc Frequent users Predictors of frequent emergency department visits among hospitalized cancer patients: a comparative cohort study using integrated clinical and administrative data to improve care delivery
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topic_title	Predictors of frequent emergency department visits among hospitalized cancer patients: a comparative cohort study using integrated clinical and administrative data to improve care delivery Emergency department visits (dpeaa)DE-He213 Cancer (dpeaa)DE-He213 Cohort study (dpeaa)DE-He213 Frequent users (dpeaa)DE-He213
topic	misc Emergency department visits misc Cancer misc Cohort study misc Frequent users
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title	Predictors of frequent emergency department visits among hospitalized cancer patients: a comparative cohort study using integrated clinical and administrative data to improve care delivery
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title_full	Predictors of frequent emergency department visits among hospitalized cancer patients: a comparative cohort study using integrated clinical and administrative data to improve care delivery
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journal	BMC health services research
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author_browse	Kurteva, Siyana Tamblyn, Robyn Meguerditchian, Ari N.
container_volume	23
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author-letter	Kurteva, Siyana
doi_str_mv	10.1186/s12913-023-09854-1
title_sort	predictors of frequent emergency department visits among hospitalized cancer patients: a comparative cohort study using integrated clinical and administrative data to improve care delivery
title_auth	Predictors of frequent emergency department visits among hospitalized cancer patients: a comparative cohort study using integrated clinical and administrative data to improve care delivery
abstract	Background Frequent emergency department (FED) visits by cancer patients represent a significant burden to the health system. This study identified determinants of FED in recently hospitalized cancer patients, with a particular focus on opioid use. Methods A prospective cohort discharged from surgical/medical units of the McGill University Health Centre was assembled. The outcome was FED use (≥ 4 ED visits) within one year of discharge. Data retrieved from the universal health insurance system was analyzed using Cox Proportional Hazards (PH) model, adopting the Lunn-McNeil approach for competing risk of death. Results Of 1253 patients, 14.5% became FED users. FED use was associated with chemotherapy one-year pre-admission (adjusted hazard ratio (aHR) 2.60, 95% CI: 1.80–3.70), ≥1 ED visit in the previous year (aHR: 1.80, 95% CI 1.20–2.80), ≥15 pre-admission ambulatory visits (aHR 1.54, 95% CI 1.06–2.34), previous opioid and benzodiazepine use (aHR: 1.40, 95% CI: 1.10–1.90 and aHR: 1.70, 95% CI: 1.10–2.40), Charlson Comorbidity Index ≥ 3 (aHR: 2.0, 95% CI: 1.2–3.4), diabetes (aHR: 1.60, 95% CI: 1.10–2.20), heart disease (aHR: 1.50, 95% CI: 1.10–2.20) and lung cancer (aHR: 1.70, 95% CI: 1.10–2.40). Surgery (cardiac (aHR: 0.33, 95% CI: 0.16–0.66), gastrointestinal (aHR: 0.34, 95% CI: 0.14–0.82) and thoracic (aHR: 0.45, 95% CI: 0.30–0.67) led to a decreased risk of FED use. Conclusions Cancer patients with higher co-morbidity, frequent use of the healthcare system, and opioid use were at increased risk of FED use. High-risk patients should be flagged for preventive intervention. © The Author(s) 2023
abstractGer	Background Frequent emergency department (FED) visits by cancer patients represent a significant burden to the health system. This study identified determinants of FED in recently hospitalized cancer patients, with a particular focus on opioid use. Methods A prospective cohort discharged from surgical/medical units of the McGill University Health Centre was assembled. The outcome was FED use (≥ 4 ED visits) within one year of discharge. Data retrieved from the universal health insurance system was analyzed using Cox Proportional Hazards (PH) model, adopting the Lunn-McNeil approach for competing risk of death. Results Of 1253 patients, 14.5% became FED users. FED use was associated with chemotherapy one-year pre-admission (adjusted hazard ratio (aHR) 2.60, 95% CI: 1.80–3.70), ≥1 ED visit in the previous year (aHR: 1.80, 95% CI 1.20–2.80), ≥15 pre-admission ambulatory visits (aHR 1.54, 95% CI 1.06–2.34), previous opioid and benzodiazepine use (aHR: 1.40, 95% CI: 1.10–1.90 and aHR: 1.70, 95% CI: 1.10–2.40), Charlson Comorbidity Index ≥ 3 (aHR: 2.0, 95% CI: 1.2–3.4), diabetes (aHR: 1.60, 95% CI: 1.10–2.20), heart disease (aHR: 1.50, 95% CI: 1.10–2.20) and lung cancer (aHR: 1.70, 95% CI: 1.10–2.40). Surgery (cardiac (aHR: 0.33, 95% CI: 0.16–0.66), gastrointestinal (aHR: 0.34, 95% CI: 0.14–0.82) and thoracic (aHR: 0.45, 95% CI: 0.30–0.67) led to a decreased risk of FED use. Conclusions Cancer patients with higher co-morbidity, frequent use of the healthcare system, and opioid use were at increased risk of FED use. High-risk patients should be flagged for preventive intervention. © The Author(s) 2023
abstract_unstemmed	Background Frequent emergency department (FED) visits by cancer patients represent a significant burden to the health system. This study identified determinants of FED in recently hospitalized cancer patients, with a particular focus on opioid use. Methods A prospective cohort discharged from surgical/medical units of the McGill University Health Centre was assembled. The outcome was FED use (≥ 4 ED visits) within one year of discharge. Data retrieved from the universal health insurance system was analyzed using Cox Proportional Hazards (PH) model, adopting the Lunn-McNeil approach for competing risk of death. Results Of 1253 patients, 14.5% became FED users. FED use was associated with chemotherapy one-year pre-admission (adjusted hazard ratio (aHR) 2.60, 95% CI: 1.80–3.70), ≥1 ED visit in the previous year (aHR: 1.80, 95% CI 1.20–2.80), ≥15 pre-admission ambulatory visits (aHR 1.54, 95% CI 1.06–2.34), previous opioid and benzodiazepine use (aHR: 1.40, 95% CI: 1.10–1.90 and aHR: 1.70, 95% CI: 1.10–2.40), Charlson Comorbidity Index ≥ 3 (aHR: 2.0, 95% CI: 1.2–3.4), diabetes (aHR: 1.60, 95% CI: 1.10–2.20), heart disease (aHR: 1.50, 95% CI: 1.10–2.20) and lung cancer (aHR: 1.70, 95% CI: 1.10–2.40). Surgery (cardiac (aHR: 0.33, 95% CI: 0.16–0.66), gastrointestinal (aHR: 0.34, 95% CI: 0.14–0.82) and thoracic (aHR: 0.45, 95% CI: 0.30–0.67) led to a decreased risk of FED use. Conclusions Cancer patients with higher co-morbidity, frequent use of the healthcare system, and opioid use were at increased risk of FED use. High-risk patients should be flagged for preventive intervention. © The Author(s) 2023
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title_short	Predictors of frequent emergency department visits among hospitalized cancer patients: a comparative cohort study using integrated clinical and administrative data to improve care delivery
url	https://dx.doi.org/10.1186/s12913-023-09854-1
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FED use was associated with chemotherapy one-year pre-admission (adjusted hazard ratio (aHR) 2.60, 95% CI: 1.80–3.70), ≥1 ED visit in the previous year (aHR: 1.80, 95% CI 1.20–2.80), ≥15 pre-admission ambulatory visits (aHR 1.54, 95% CI 1.06–2.34), previous opioid and benzodiazepine use (aHR: 1.40, 95% CI: 1.10–1.90 and aHR: 1.70, 95% CI: 1.10–2.40), Charlson Comorbidity Index ≥ 3 (aHR: 2.0, 95% CI: 1.2–3.4), diabetes (aHR: 1.60, 95% CI: 1.10–2.20), heart disease (aHR: 1.50, 95% CI: 1.10–2.20) and lung cancer (aHR: 1.70, 95% CI: 1.10–2.40). Surgery (cardiac (aHR: 0.33, 95% CI: 0.16–0.66), gastrointestinal (aHR: 0.34, 95% CI: 0.14–0.82) and thoracic (aHR: 0.45, 95% CI: 0.30–0.67) led to a decreased risk of FED use. Conclusions Cancer patients with higher co-morbidity, frequent use of the healthcare system, and opioid use were at increased risk of FED use. 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Predictors of frequent emergency department visits among hospitalized cancer patients: a comparative cohort study using integrated clinical and administrative data to improve care delivery

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