Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Lifespan Biostatistics, Epidemiology, Research Design Core, Providence, RI, USA.
Ann Palliat Med. 2024 Jan;13(1):93-100. doi: 10.21037/apm-23-80. Epub 2024 Jan 10.
After-hour calls can be resource intensive and remain a significant challenge to medical practices, though they have historically been poorly or non-reimbursable services. This study reviews after-hour calls from hematology/oncology patients at a cancer center to characterize after-hour care needs, identify care gaps, and look for opportunities to improve outpatient healthcare delivery.
This descriptive, retrospective Institutional Review Board-approved study analyzed patient calls between June 2015 to February 2021 in an academic hematology/oncology practice. Data from 500 calls were reviewed and cataloged into a database including patient demographics, clinical history, and information surrounding the call (e.g., primary reason for the call, outcome of the call). Calls were also categorized as being urgent or not from a patient or provider's perspective.
Among 500 calls, representing 398 unique patients, the average patient was 62 years old and 52% of calls were from females. Most calls were made to report symptoms (65%), followed by calls to follow-up on labs, tests, or imaging (13%), and clarifying treatment plans (10%). Oncology patients represented 67% of calls and hematology (malignant and benign) patients represented 33%. More specifically, patients with gastrointestinal cancer (25%), hematologic malignancies (24%), and thoracic cancer (13%) represented the diagnoses with the highest call volume.
This study explores the complexity and variety of after-hour cancer patient calls. By systematically exploring patient calls, this data can provide insight into patients' needs outside of regular clinic times and help practices develop strategies to anticipate these needs, reduce after-hour call burden, and improve overall quality of care.
尽管医疗实践中，夜间电话仍然是一项资源密集型工作，且具有挑战性，但它们在历史上一直是服务质量差或无法报销的服务。本研究通过回顾癌症中心血液科/肿瘤科患者的夜间电话，以明确夜间护理需求、发现护理差距，并寻找改善门诊医疗服务的机会。
本研究为描述性、回顾性研究，经机构审查委员会批准，分析了 2015 年 6 月至 2021 年 2 月期间在学术血液科/肿瘤科实践中的患者来电。对 500 次来电的数据进行了审查，并将其分类到数据库中，包括患者人口统计学、临床病史以及来电相关信息（例如，来电的主要原因、来电结果）。来电还根据患者或提供者的视角分为紧急或非紧急。
在 500 次来电中，代表 398 位不同的患者，平均年龄为 62 岁，52%的来电来自女性。大多数来电是报告症状（65%），其次是跟进实验室、检查或影像（13%），以及澄清治疗计划（10%）。肿瘤患者占来电的 67%，血液科（恶性和良性）患者占 33%。更具体地说，胃肠道癌（25%）、血液恶性肿瘤（24%）和胸部癌症（13%）患者的来电量最高。
本研究探讨了夜间癌症患者来电的复杂性和多样性。通过系统地探索患者来电，这些数据可以深入了解患者在常规就诊时间之外的需求，并帮助实践制定策略来预测这些需求，减轻夜间电话负担，提高整体护理质量。
