![]() A Canadian study revealed that 76,759 patients visited the emergency department 194,017 times during their final 6 months of life. Multiple previous studies have demonstrated that patients with advanced cancer have a high rate of emergency department visits. Significant barriers to providing appropriate palliative care in the ED include the absence of long-term relationships between ED physicians and patients insufficient staff training in symptom management and essential communication skills, such as discussing the goal of care and advance care planning. ![]() This can be attributed to several factors, including long wait times due to their patients’ ranking second to critically ill patients, a lack of adequate symptom palliation, ineffective communication due to the noisy and impersonal environment, and a lack of dedicated space for relatives to wait for examinations or a place to discuss advance care planning during the final stages of life. Generally, patients and families describe these visits as unpleasant experiences. The frequent emergency department (ED) visits of patients with advanced cancer indicated unmet palliative care needs and the low quality of palliative care at the end of life. Patients having a lower PPS were associated with a lower risk of ED visits. There was reduced ED utilization among cancer patients with > 100 days of palliative care. In the multiple logistic regression analysis, these two factors remained associated with ED visits:> 100 days from the palliative consultation (OR 0.18 95%CI 0.06, 0.55 p-value 0.01) and PPS 50–90% (OR 2.62 95%CI 1.44, 4.79 p-value 0.01). The variables with a P value 100 days from palliative consultation (OR 0.23 95%CI 0.08, 0.66 p-value 0.01) were less likely to attend the ED. To investigate the factors associated with ED visits, a logistic regression analysis was conducted. The time between the initial palliative consultation and study endpoints was categorized into three groups: 16 days, 16–100 days, and > 100 days, based on the literature review. The trial ended when the patients died, were referred to other palliative programs, or the study ended. Patients were excluded if they had died at the initial consultation, were referred to other programs at the initial consultation, or had an incomplete record. All patients older than 18 were included. Eligible patients were previously enrolled in the comprehensive palliative care program prior to their ED visit. MethodsĪ retrospective study was conducted between January and December, 2019. We aimed to investigate the factors that contribute to ED visits among patients with advanced cancer in order to identify strategies for reducing unnecessary ED visits among these patients. This indicates unmet needs and poor-quality palliative care. Several studies demonstrated that cancer patients visited the emergency department (ED) frequently.
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