Health Care Utilization From Chemotherapy-Related Adverse Events Among Low-Income Breast Cancer Patients

Goyal, Ravi; Wheeler, Stephanie B.; Kohler, Racquel E.; Lich, Kristen Hassmiller; Lin, Ching-Ching; Reeder‐Hayes, Katherine E.; Meyer, Anne Marie; Mayer, Deborah K.

doi:10.18043/ncm.75.4.231

Cited by 22 publications

(48 citation statements)

References 25 publications

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“…After recalculating these rates to permit comparison across studies, 7% to 12% of the patients in the study evaluating all cancers had an ED visit, 33 followed by 5% to 12% of gynecological cancer patients, 29,35 2% to 10% of colon cancer patients, 27,31,37 3% to 5% of prostate cancer patients, 28,41 4% of lung cancer patients, 37 and 1% to 2% of breast cancer patients. 32,34,37 Using the 30-day visit rate, studies that examined postsurgical periods demonstrated 2% to 12% of the sample visited an ED within 30 days after surgery, 27–2,31 and the study that examined only chemotherapy showed a 5% 30-day visit rate. 35 Those that examined the period after diagnosis had between 1% and 12% 30-day ED visit rates.…”

Section: Resultsmentioning

confidence: 99%

“…38,40 Enabling factors associated with increased ED use were urban compared with rural residence, 36 residing in a state in which Medicaid copayments increased and prescription drug and other benefits were reduced, 33 and being unmarried compared with married. 36 Need factors that predicted increased ED use were having a radical prostatectomy compared with no treatment, 36 surviving at least 1 year from diagnosis, 40 having more severe symptoms, 39 having a greater number of comorbidities, 34,39,41 being eligible for Medicaid due to blindness or disability, 34 receiving chemotherapy versus no chemotherapy, 34 residing in a census tract with low median income, 36 and having no treatment compared with radiation therapy. 36 Cancer stage is also considered a need factor that could influence ED use; however, results for the impact of cancer stage were less consistent.…”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review of Emergency Department Use Among Cancer Patients

et al. 2017

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Background Recent reports call for reductions in costly and potentially avoidable services such as emergency department (ED) visits. Providing high-quality and safe care for oncology patients remains challenging for ED providers given the diversity of patients seeking care and the unpredictable clinical environment. While ED use by oncology patients is appropriate for acute health concerns, some ED visits may be preventable with well-coordinated care and adequate symptom management. Objective The aim of this study was to summarize available evidence regarding the incidence, predictors of, and reasons for ED visits among oncology patients. Methods Keyword/MeSH term searches were conducted using 4 online databases. Inclusion criteria were publication date between April 1, 2003, and December 5, 2014; sample size of 50 or more; and report of the incidence or predictors of ED use among oncology patients. Results The 15 studies that met criteria varied in study aim, design, and time frames for calculating ED utilization rates. The incidence of ED visits among oncology patients ranged from 1% to 83%. The 30-day standardized visit rate incidence ranged from 1% to 12%. Collectively, the studies lack population-based estimates for all cancers combined. Conclusions The studies included in this review suggest that rates of ED use among cancer patients exceed those of the general population. However, the extent of ED use by oncology patients and the reasons for ED visits remain understudied. Implications for Practice Nurses are involved in the treatment of cancer, patient education, and symptom management. Nurses are well positioned to develop patient-centered treatment and care coordination plans to improve quality of care and reduce ED visits.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Emergency Department Use Among Cancer Patients

et al. 2017

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“…Programs to improve coordination of care between cancer care specialists and primary care providers are necessary and may help to improve outcomes and reduce costs. For example, in the original article by Goyal and colleagues [26], the authors explore the role of patient-centered medical homes in potentially reducing health care utilization associated with chemotherapy-related adverse events among breast cancer patients. Their study found that Medicaid patients had significantly fewer inpatient admissions associated with chemotherapy-related adverse events if they were enrolled in Community Care of North Carolina (CCNC), which uses a medical-home model to provide care, than if they were not enrolled in CCNC.…”

Section: Effects Of Cancer On Physical Health Mental Health and Finmentioning

confidence: 99%

“…ICISS also exemplifies the wealth of health care research activities in North Carolina, which have the potential to inform policy and improve quality of care in and beyond the state. Notably, ICISS data were used for both of the original articles featured in this issue [7,26]. This table is available in its entirety in the online edition of the NCMJ.…”

Section: Special Issues In Cancer Research In North Carolinamentioning

confidence: 99%

Cancer Care Research in North Carolina

Wheeler

Basch

2014

North Carolina Medical Journal

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“…Studies have consistently demonstrated that individuals with a medical home benefit from improved quality of care in the treatment of chronic diseases, including diabetes and asthma [9,16–18]. Further, medical homes improve outcomes for individuals who receive treatment for specialty-intensive conditions, including SMI [19–21]. …”

Section: Introductionmentioning

confidence: 99%

Evaluating the potential for primary care to serve as a mental health home for people with schizophrenia

Grove

Olesiuk

Ellis

et al. 2017

General Hospital Psychiatry

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Objective Primary care-based medical homes could improve the coordination of mental health care for individuals with schizophrenia and comorbid chronic conditions. The objective of this paper is to examine whether persons with schizophrenia and comorbid chronic conditions engage in primary care regularly, such that primary care settings have the potential to serve as a mental health home. Method We examined the annual primary care and specialty mental health service utilization of adult North Carolina Medicaid enrollees with schizophrenia and at least one comorbid chronic condition who were in a medical home during 2007–2010. Using a fixed-effects regression approach, we also assessed the effect of medical home enrollment on utilization of primary care and specialty mental health care and medication adherence. Results A substantial majority (78.5%) of person-years had at least one primary care visit, and 17.9% had at least one primary care visit but no specialty mental health services use. Medical home enrollment was associated with increased use of primary care and specialty mental health care, as well as increased medication adherence. Conclusions Medical home enrollees with schizophrenia and comorbid chronic conditions exhibited significant engagement in primary care, suggesting that primary-care-based medical homes could serve a care coordination function for persons with schizophrenia.

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Health Care Utilization From Chemotherapy-Related Adverse Events Among Low-Income Breast Cancer Patients

Cited by 22 publications

References 25 publications

A Systematic Review of Emergency Department Use Among Cancer Patients

A Systematic Review of Emergency Department Use Among Cancer Patients

Cancer Care Research in North Carolina

Evaluating the potential for primary care to serve as a mental health home for people with schizophrenia

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