title: Cancer Transitional Care for Terminally Ill Cancer Patients Can Reduce the Number of Emergency Admissions and Emergency Department Visits.
abstract: BACKGROUND
  Emergency admissions and emergency department visits (EAs/EDVs) have been used as quality indicators of home care in terminally ill cancer patients. We established a cancer transitional care (CTC) program to monitor and manage terminally ill cancer patients receiving care at home. The purpose of this study was to evaluate the effectiveness of CTC by the frequency of EAs/EDVs.
  
  
  METHODS
  In a retrospective chart review, we identified 133 patients with cancer admitted to our department, of whom 56 met study eligibility criteria. The CTC consisted of at least 1 or more following components: (1) a 24-hour hotline for general physicians or home care nurses to reach hospital-based physicians, (2) periodic phone calls from an expert hospital-based oncology nurse to home care medical staff, and (3) reports sent to our department from home care medical staff. The primary outcome variable was the frequency of EAs/EDVs.
  
  
  RESULTS
  There were 32 EAs/EDVs and 69 planned admissions during the observation period. In the last 30 days of life, 16 patients (28.6%) had 1 EA/EDV and none had multiple EAs/EDVs. Compared with previous studies, our study found a similar or lower frequency of EAs/EDVs.
  
  
  CONCLUSIONS
  Our findings suggest that the implementation of CTC reduces the number of EAs/EDVs by replacing them with planned admissions. Further prospective studies to evaluate CTC are warranted.
authors.affiliation: 1 Department of Palliative Medicine, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Shimada
authors.affiliation: 1 Department of Palliative Medicine, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Ishiki
authors.affiliation: 1 Department of Palliative Medicine, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Iwase
authors.affiliation: 1 Department of Palliative Medicine, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Tsukuru
authors.initials: T
authors.lastname: Chiba
authors.affiliation: 1 Department of Palliative Medicine, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Fujiwara
authors.affiliation: 1 Department of Palliative Medicine, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Watanabe
authors.affiliation: 1 Department of Palliative Medicine, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Kinkawa
authors.affiliation: 2 Center for Translational Research, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Nojima
authors.affiliation: 1 Department of Palliative Medicine, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.|3 Department of Hematology/Oncology, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Arinobu
authors.initials: A
authors.lastname: Tojo
authors.affiliation: 4 Center for Antibody and Vaccine Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
authors.forename: Kohzoh
authors.initials: K
authors.lastname: Imai
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D015277:Hotlines; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D010343:Patient Admission / Q000706:statistics & numerical data*; D010348:Patient Care Team; D012189:Retrospective Studies; D012737:Sex Factors; D013689:Telephone; D019452:Terminally Ill
keywords: emergency admission; emergency department visit; home care; palliative care; quality of life; terminally ill cancer patients