Oncology rapid assessment clinic and effect on ED visits.

Abstract

258 Background: The use of the Emergency Department (ED) by oncology patients for lower acuity issues is common. Oncology Rapid Assessment Clinics (ORAC) may play a key role in reducing ED visits among oncology patients. We analyzed whether the advent of ORAC was associated with lower ED utilization by patients receiving cancer care at University of Chicago Medical Center (UCMC). Methods: UCMC opened its ORAC in March 2019 to provide supportive care and symptom management to cancer patients who needed acute medical issues addressed. To identify active cancer patients, we identified those that had either a forward or reverse 9 month rolling count of greater than or equal to 2 Outpatient Clinic Visits (complete or future). Of all those patients, we identified any ED visit made within the time period considered Pre-ORAC (6/2018-2/2019) and Post-ORAC (6/2019-2/2020). To determine effect of ORAC on ED utilization, we performed t-test comparison of rates. Results: A total of 9,043 unique patients were seen in the Pre-ORAC period and 8,753 in the Post-ORAC period. Predominant cancers seen in both periods were Breast, Lung/Head & Neck, GI, Lymphoma/Leukemia, GU, and Multiple Myeloma. The ED visit rate was 0.252 (2279/9043) in Pre-ORAC period and 0.237 (2075/8753) in the Post-ORAC period (p = 0.02). Conclusions: There was a decrease in ED visit rates for oncology patients cared for by UCMC in the immediate period after the opening of the ORAC clinic. More substantial declines are expected in the future as the capacity and efficiency of the ORAC clinic grows and the concept is socialized among cancer providers.