Background: High quality local services and well co-ordinated care is important for improving outcomes for cancer patients. Number of cancer patients in regional Victoria is increasing and a Resident Oncology Service (ROS) was set up to provide an easily accessible service. The aim of this review was to gain information about solid tumour patients presenting to regional hospitals following chemotherapy.
Methods: Retrospective review of all oncology patients managed in the Emergency Department (ED) from July 2011 to December 2011 and January 2012 to Jun 2012 was performed.
Results: 319 patients with solid cancer visited the ED during the twelve months period, 150 before ROS and 169 after, with a cancer type break down of 31.6% GI, 23.2% breast, 10.7% lungs, 9.4% hepatobiliary, and 25.1% others. 51.3% and 63.9% of patients presenting before and after ROS establishment, respectively, had metastatic disease. There was an increase in presentations related to disease progression (27.3% against 31.3%) and infection (10.7 against 16.0), but a decrease in presentations related to treatment complications (30% against 21.9%) and non-cancer related problem (32% against 30.8%) post ROS. There is 24% and 18.4% relative increase in the numbers of patients receiving antibiotics and anticoagulation, respectively, but a 14.5% reduction in those requiring pain control. There was a 7.1% relative reduction in the number of admissions post ROS. Median duration of admission before and after ROS were 4 (range, 1-18 days) and 4 (range 1-45 days).
Conclusion: ROS plays an important role in managing oncology patients in regional areas. Improving the protocols in the ED would lead to improvements in service and better co-ordinated service for regional cancer patients.