Likelihood of unplanned readmission among oncology patients with a completed post-discharge follow-up encounter.

Abstract

11035 Background: Literature suggests that oncology patients are more likely to be admitted from the emergency department to the hospital than patients without a cancer diagnosis 1 . Avoiding unplanned readmissions (UR) becomes a joint responsibility of the patient and the oncology care team. The premise of one ASCO Certified standard is that patients who receive post-discharge follow-up (PDFU) may avoid a readmission if their needs are addressed promptly in the outpatient setting. We evaluated the impact of completion of a PDFU after an index admission on URs. Methods: We performed a retrospective analysis of patients with an index admission to a system hospital between January and November 2024. Included were patients with a discharge (d/c) to home and an encounter with an oncology provider within the past year. We compared the overall proportion of patients with any UR in the measurement period between those patients who did and did not complete a PDFU, as well as that of patients who completed an early PDFU (within 3 days of d/c) and a later PDFU (between 4-7 days of d/c). PDFUs are defined as a telemedicine or clinic encounter within 7 days of the d/c date. Chi Squared analysis was utilized to evaluate if PDFU reduced UR. Results: 2,533 d/cs occurred within the measurement period. 542 (21%) of encounters resulted in a UR. 1,057 (42%) encounters had a PDFU. Of the 1,057 encounters where a PDFU was completed, 240 (23%) resulted in a UR. Of the 1,476 encounters where a PDFU was not completed, 302 (20%) resulted in a UR. The findings were not clinically significant. Chi-squared p-value: .17 Conclusions: Completion of a PDFU is not a factor in predicting an oncology patient’s potential unplanned readmission. In addition, excluding some high risk patients such as those with hematologic malignancies did not change the overall analysis. We found no difference in rate of UR among patients who completed a PDFU within 3 days or 4-7 days. Further investigation is needed to better understand if modifiable factors contributed to UR in this cohort. Other factors need to be considered, such as patient risk for unplanned re-admission, in evaluating the impact of PDFU on UR, as expected in the ASCO Certified standard. 1 Waters TM; Kaplan CM, Graetz I, et al. (2019) Patient-Centered Medical Homes in Community Oncology Practices: Changes in Spending and Care Quality Associated with the COME HOME Experience. Journal of Oncology Practice, 15(1), e56-e64. Proportion of d/cs with UR by PDFU completion. No UR # d/c (%) Yes UR# d/c (%) Yes PDFU 817 (77%) 240 (23%) No PDFU 1174 (80%) 302 (20%)