DALLAS – Oct. 24, 2023 – Recently diagnosed cancer patients often decide on their own to visit hospital emergency departments (EDs) for symptoms that don’t warrant that type of care, UT Southwestern Medical Center researchers report. Their study's results, published in the American Journal of Managed Care, could help patients safely avoid going to the ED.

“Many health system telephone answering messages advise callers that ‘if this is a medical emergency, please hang up and dial 911.’ Our findings point out that patients with cancer are often referring themselves to the ED for nonemergency issues, so they may need more directed clinical advice,” said study leader Arthur Hong, M.D., M.P.H., Assistant Professor of Internal Medicine and in the Peter O’Donnell Jr. School of Public Health at UT Southwestern. Dr. Hong, a member of the Division of General Internal Medicine and the Harold C. Simmons Comprehensive Cancer Center, is a Texas Health Resources Clinical Scholar.

Cancer patients frequently experience a range of disease- and treatment-related symptoms, and those who are fearful or confused may make a default decision to go to the emergency room. However, Dr. Hong said, some of these visits can be avoided; patients may be better served visiting a cancer-specific urgent care center. Although most cancer care providers offer nurse triage phone lines 24 hours a day, seven days a week to dispense advice, it has been unclear how often patients use them to decide whether an ED visit is appropriate.
To answer this question, Dr. Hong and his colleagues evaluated data from the tumor registries of UT Southwestern and Parkland Health, a public safety-net health system for the uninsured that serves as the primary teaching hospital for UTSW. The researchers identified 39,498 adults with a new cancer diagnosis between 2012 and 2018, then compared records from these patients to those in a database of ED visits within six months of diagnosis. That database is maintained by the Dallas-Fort Worth Hospital Council Foundation, which keeps records of 12 million patients within a 100-mile radius of Dallas including details of their hospital visits.

Just over 40% of the patients made no ED visits in the six months after their diagnoses, but about 50% made one to three, and nearly 10% had four or more. Of patients who made ED visits, about 81% always self-referred, about 7% relied on medical advice at least once, and about 12% always called for triage help before an ED visit.

Although more than half of these visits ended in hospitalizations and a quarter were classified as emergencies but didn’t require hospitalization, another quarter did not require emergency care. These nonemergency visits were more likely for patients who did not consult a nurse triage line, went to the ED on weekends or holidays, or went to EDs closer to their home.

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