Authors: Ameri M, Ali N, Dickson K, Koom-Dabzie K, Al-Ameri A.
Background: The management of cancer patients is complex and usually requires hospital admission in order to diagnose and treat complications related to cancer or its therapies. Solid tumor patients have a mean length of stay (LOS) of about 6 to 9 days. A large portion of the cancer patients has extended length of stay more than 10 days. Long hospital stays utilize more resources and is more expensive.
Methods: We aimed to assess characteristics of patients with an extended length of stay at UT MD Anderson OncoHospitalist service in 2019 to identify focus areas that can help decrease extended LOS.
Results: 172 out of 1449 patients with extended LOS were analyzed. This study has a 95% confidence interval of finding the true value within (±7%) of the real value. The results showed that 84% of prolonged admissions were due to medical issues and 18% of the patients were either discharged to hospice or died during their hospital stay. Further breakdown of the medical reasons for extended LOS indicated less 4% of these patients received inpatient radiation therapy; around 3% had complications from immunotherapy; 2% patients had issues with pain control and 7% of these patients had issues with placement. Overall, 50% of the patients who had issues with placement had Medicare and 25% had no health insurance. The study was unable to determine any association between the distances of primary residence from hospital to extended LOS.
Conclusion: The study was able to identify focus areas such as early Goals of Care (GOC) in end-of-life care, protocolization of immunotherapy adverse reaction therapy, and criteria-based approach to earlier radiation oncology consultation for palliative radiation therapy. All of which will help decrease the extended LOS at places like UT MD Anderson and others.