Patient selection: advanced gastrointestinal tract cancer
Most common reasons for admission:
(1) gastrointestinal tract obstruction
(2) abdominal pain
(3) fever or infection
Factors associated with potentially avoidable admissions:
(1) age >= 70 years of age
(2) advised by oncologist to consider hospice
(3) most recent chemotherapy was third line or greater palliative chemotherapy (indicative of refractory cancer)
Premises of study:
(1) A patient with advanced cancer should enter hospice rather than be admitted to the hospital.
(2) Aggressive chemotherapy has adverse effects which can lead to a hospital admission, but the therapy may be futile for a patient with advanced cancer.
(3) Coordinated care and effective outpatient management can reduce hospital admissions. Uncoordinated care, poor outpatient care and/or oversights can result in avoidable admissions.
