title: Mixed method exploration of the medical, service-related, and emotional reasons for emergency room visits of older cancer patients.
abstract: When dealing with health issues, older cancer patients are likely to visit emergency rooms (ER), which are known to expose these patients to the risk of adverse outcomes. Little is known about the profile and reasons for such visits. The aim of this study is (1) to describe the profile of elderly cancer patients aged 70 years and older who visited the ER of a regional hospital in Québec, Canada, and (2) to explain the medical reasons and factors determining such visits from the patients' perspective.
  
  
  
  A concurrent mixed method design was used. Descriptive analysis of administrative databases was conducted to describe the socio-demographic, clinical, and service utilization profile of 792 cancer patients aged 70 years and older. Content analysis of 11 semi-structured interviews of a sub-sample was subsequently performed to better understand the experience and meaning these patients attribute to this health behaviour.
  
  
  
  The sample of 792 older cancer patients made a total of 1572 ER visits. Most visits occurred during the daytime. More than half (53 %) of the patients were discharged, and close to 40 % were hospitalized. The most frequent reasons for consulting were respiratory (15.8 %), digestive (13.4 %), neurological (8.3 %), fever or infection-related (8.3 %), and cardiovascular (8.2 %). Content analysis of the qualitative data suggested that patients made ER visits mostly when other cancer care services were unavailable or because of a serious life-threatening health condition.
  
  
  
  The study suggests areas of improvement to prevent ER visits when health issues can be addressed by other care services.
authors.affiliation: School of Nursing, Université de Sherbrooke, Québec, Canada. Bich.lien.nguyen@usherbrooke.ca.|CSSS Champlain-Charles-Le Moyne, Greenfield Park, Québec, Canada. Bich.lien.nguyen@usherbrooke.ca.|Charles-Le Moyne Hospital Research Centre, Longueuil, Canada. Bich.lien.nguyen@usherbrooke.ca.
authors.forename: Bich-Lien
authors.initials: BL
authors.lastname: Nguyen
authors.affiliation: School of Nursing, Université de Sherbrooke, Québec, Canada.|Charles-Le Moyne Hospital Research Centre, Longueuil, Canada.
authors.forename: Dominique
authors.initials: D
authors.lastname: Tremblay
authors.affiliation: School of Nursing, Université de Sherbrooke, Québec, Canada.|Research Centre on Aging-CSSS-IUGS, Sherbrooke, Canada.
authors.forename: Luc
authors.initials: L
authors.lastname: Mathieu
authors.affiliation: Division of Social and Transcultural Psychiatry, McGill University, Québec, Canada.|Culture and Mental Health Research Unit, Lady Davis Medical Institute, Jewish General Hospital, Montréal, Canada.
authors.forename: Danielle
authors.initials: D
authors.lastname: Groleau
mesh_terms: D000367:Age Factors; D000368:Aged; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D011792:Quebec / Q000453:epidemiology; D066252:Sociological Factors
keywords: Emergency services; Geriatric oncology; Healthcare experience; Service utilization; Unmet needs