Health
Study reveals emergency department use among cancer patients in Ontario.
Approximately one in three patients diagnosed with cancer in Ontario visited an emergency department (ED) in the 90 days before diagnosis, a new study published in 2016 finds. . CMJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.240952.
A study of more than 650,000 patients diagnosed with cancer in Ontario between 2014 and 2021 found that 35% (229,683 people) visited an emergency department in the 90 days before diagnosis. was. Among patients who visited the emergency department before being diagnosed with cancer, 64% had one visit, 23% had two visits, and 13% had three or more visits. More than half (51%) of patients presenting to the ED prior to diagnosis were hospitalized.
“The emergency department is not an ideal environment to manage patients with suspected cancer.” wrote lead author Dr. Keerat Grewal, an emergency physician and clinical scientist at the Schwartz/Reisman Institute of Emergency Medicine and ICES at Mount Sinai Hospital in Toronto, Ontario, and co-authors.Emergency departments are always crowded and privacy is limited. Receiving a suspected cancer diagnosis in these circumstances has been described as distressing for patients.”
Although emergency departments typically provide acute and episodic treatment, most emergency departments are not equipped to provide ongoing care after a suspected cancer is diagnosed. This is essential to confirm the diagnosis and ensure that the patient is referred to the appropriate specialist.
”Some patients may require hospitalization for symptoms or complications related to the development of cancer, but may rely on hospitalization to ensure or expedite testing and follow-up by the emergency department. are costly and contribute to hospital overcrowding, especially when these can be implemented. In the field of outpatient treatment,” writes the author.
Most emergency department visits were related to symptoms of the type of cancer diagnosed. The patient, who was later diagnosed with colorectal cancer, presented to the emergency department related to intestinal obstruction and obstruction. abdominal paina patient with gastroesophageal cancer presented to the emergency department related to gastrointestinal bleeding, dysphagia, and abdominal pain. Brain tumor patients were more likely to present to the emergency department before being diagnosed with weakness, confusion, or seizures.
Several patient groups are diagnosed with cancer, including the elderly, those from rural and northern regions, those living in marginalized communities, those with multiple illnesses, and those diagnosed during the COVID-19 pandemic. They were more likely to have used ED before. Patients who immigrated within the past 5 years were less likely to have used the ED before diagnosis.
The results were consistent with those of earlier studies in the UK and US.
The researchers used administrative data from ICES. They call for further research into why these patient groups use the ED more frequently, and to move from the emergency stage of cancer diagnosis to further cancer workup to improve patient care and outcomes. It emphasizes the need to ensure equitable access.
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Reference magazines:
Grewal, K. others. (2024) Emergency department utilization prior to cancer diagnosis in Ontario, Canada: a population-based study. Canadian Medical Association Journal. doi.org/10.1503/cmaj.240952.
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