New Report on Emergency Department Utilisation By People with Cancer

With very little information on how and why people with cancer visit an emergency department available,  a new report by the Bureau of Health Information (BHI) and the Cancer Institute NSW has shed light on the subject.
The report, Emergency department utilisation by people with cancer, is the first time that data from the NSW Cancer Registries, emergency department (ED) and hospital databases have been linked to track the journey of cancer patients using EDs in NSW.
BHI Director of System and Thematic Reports, Dr Kim Sutherland said the research was important because EDs are not always the most appropriate places to care for people with cancer.
“Among people with cancer, 10 per cent attended an ED three times or more in the year following their diagnosis. “Providing an understanding of why and how often patients with cancer attended an ED, particularly around the time of their cancer diagnosis, helps inform efforts to provide better alternatives to ED visits,” Dr Sutherland said.
The report also compared EDs on timeliness measures in treating, discharging and admitting cancer patients; and analysed whether ED use varied in the 28 days following a cancer hospitalisation.
“We found that among people who visited an ED, and were subsequently admitted to hospital, a higher proportion of people with cancer left the ED and went to a ward within four hours.
“Further analysis on breast, colorectal and respiratory cancer patients treated in NSW hospitals, found that the number of subsequent visits to an ED varied depending on the treating hospital,” Dr Sutherland said.
Chief Cancer Officer and CEO of the Cancer Institute NSW, Professor David Currow said that the research helps to further our understanding of how cancer patients are treated in NSW.
“An ED visit can be an additional stress for patients in an already difficult situation and some visits may be potentially preventable with appropriate care and community support.
“The research provides a starting point for us to look at changes that could be made to the system to minimise these preventable ED visits for people with cancer, and ensure they receive the most appropriate care at the right time," Professor Currow said.
Other results from the report include:

• reasons associated with circulatory, respiratory and digestive systems accounted for 36 percent of ED visits by cancer patients


• among people with cancer who died, 47 percent visited an ED in the 30 days preceding their death


• comorbidities, socioeconomic status and more advanced cancer resulted in a higher number of ED visits


• over half (58%) of ED visits made by people with cancer ended with admission to hospital compared to 27 percent of visits made by NSW patients.

BHI and Cancer Institute of NSW will be working with local health districts and hospitals to address the findings of the report.
The full report is available on the BHI website at www.bhi.nsw.gov.au or Cancer Institute NSW website at www.cancerinstitute.org.au