Efficacy of a clinical risk prediction tool to prioritize outreach for high-risk cancer patients.

Abstract

e13524 Background: Acute care utilization (ACU), including emergency department visits and hospitalizations, is common in patients with cancer. Prospectively identifying patients’ risk status may enable interventions to reduce ACU. We developed a REDUCE score (Reducing ED Utilization in the Cancer Experience for active oncology patients (defined as patients with an active cancer diagnosis in the last 12 months who had a Medical Oncology encounter in a 180-day period) to prospectively determine risk of ACU. The intended intervention was outreach to all high-risk patients. We evaluated the high risk group over an 11-month period (February through December 2020) to better characterize those who received outreach. Methods: Analysis of high-risk patients was conducted using a case-control method over two periods: February through June 2020 (Period 1) and July through December 2020 (Period 2) to account for a change in the type of outreach deployed. High risk was defined as REDUCE ≥2. High risk scores were stratified by those with REDUCE =2 and those with REDUCE >2. Control Group 1 consisted of high-risk patients with REDUCE =2 who did not receive outreach, and Control Group 2 included high-risk patients with REDUCE >2 who did not receive outreach. Case Group 1 consisted of high-risk patients with REDUCE =2 who had outreach, and Case Group 2 included patients with REDUCE >2 who had outreach. Average ACU per patient was compared across all groups over both periods. Descriptive statistics were applied. Results: Results are described in table 1. Average ACU per patient was higher in Periods 1 and 2 for both Case Groups, compared to both Control Groups. Over time, there was a trend in decreased ACU in the intervention group with stable to increasing ACU in the control groups. The proportion of patients who received outreach across both periods decreased in Case Group 1, but increased in Case Group 2. Conclusions: These findings suggest that patients who received outreach were at a higher risk of ACU. Further investigation revealed that there was not consistent prioritization of patients with the highest risk scores within the high-risk group for outreach. In addition to the REDUCE , ongoing efforts incorporate clinical judgment of the outreach team in assessing additional clinical risk factors to determine an intervention, which is meaningful. The REDUCE tool may provide value as an initial screening mechanism. Average ACU per patient by study group.[Table: see text]