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Clinical and economic burden of emergency department presentations for neutropenia following outpatient chemotherapy for cancer in Victoria, Australia

Livingston, Patricia M., Craike, Melinda and Slavin, Monica 2012, Clinical and economic burden of emergency department presentations for neutropenia following outpatient chemotherapy for cancer in Victoria, Australia, Oncologist, vol. 17, no. 7, pp. 998-1004.

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Title Clinical and economic burden of emergency department presentations for neutropenia following outpatient chemotherapy for cancer in Victoria, Australia
Author(s) Livingston, Patricia M.
Craike, Melinda
Slavin, Monica
Journal name Oncologist
Volume number 17
Issue number 7
Start page 998
End page 1004
Total pages 7
Publisher AlphaMed Press, Inc.
Place of publication Durham, N.C.
Publication date 2012-07
ISSN 1083-7159
Keyword(s) emergency department
chemotherapy
neutropenia
Summary Objective. To examine the clinical characteristics and financial charges associated with treating adult cancer patients receiving chemotherapy in outpatient clinics who presented to the emergency department (ED) with neutropenia.
Design and Setting.
A retrospective audit was conducted across two health services involving ED episodes and subsequent hospital admissions of patients who received chemotherapy through day oncology from January 1 to December 31, 2007 and presented to the ED with neutropenia. ED data were collected from the Victorian Emergency Minimum Dataset and charges were collected from Health Information Services. Descriptive and bivariate statistics were used to describe the patient and clinical characteristics and financial outcomes, and to explore associations between these factors.
Results.
In total, 200 neutropenic episodes in 159 outpatients were seen in the ED over the survey period. The mean patient age was 56.6 years (standard deviation, 13.2 years) and 47.2% were male. Overall, 70.0% of ED episodes were triaged as Australasian Triage Scale 2 (emergency). The median ED wait time was 10 minutes and the median ED length of stay was 6.8 hours. The median charge for each ED episode was $764.08 Australian dollars. The total combined ED and inpatient charge per episode was in the range of $144.27-$174,732.68, with a median charge of $5,640.87.
Conclusions.
This study provides important insights into the clinical and economic burden of neutropenia from both the ED and inpatient perspectives. Alternative treatment models, such as outpatient treatment, early discharge programs or prophylactic interventions to reduce the clinical and economic burden of neutropenia on our health system, must be explored.
Language eng
Field of Research 111004 Clinical Nursing: Tertiary (Rehabilitative)
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
Persistent URL http://hdl.handle.net/10536/DRO/DU:30046107

Document type: Journal Article
Collection: School of Nursing and Midwifery
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Created: Thu, 12 Jul 2012, 11:36:53 EST by Jane Moschetti

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