Logan Reid
Cancer patients often need to be admitted to the hospital for acute care or to manage refractory symptoms. This is especially true in the last months of a patient's life. Pain, nausea, and shortness of breath are the most common reasons for emergency treatment. Hospital use is not necessarily a sign of aggressive care, and inpatient care is often an unavoidable step in cancer treatment. Home care services are not always able to provide all the required assistance, and cancer patients may need urgent admission to the hospital. Chemotherapy, a common cancer treatment, can be administered at home or in the hospital, depending on the drugs and the patient's situation.
| Characteristics | Values |
|---|---|
| Cancer treatment | Chemotherapy, medication, surgery |
| Hospital admission | Cancer patients are frequently admitted to hospital, especially in urgent cases |
| Emergency treatment | Cancer patients often seek emergency treatment for pain, nausea, and shortness of breath |
| Infection risk | Hospitalisation is necessary to treat infections quickly |
| COVID-19 precautions | Screening, temperature checks, social distancing, and mask-wearing are common |
| Emotional support | Cancer treatment can be emotionally challenging, and support is available |
| Financial support | Charity care, government agencies, and patient assistance programs can help with costs |
| Transportation | Some organisations provide free transportation to treatment centres |
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What You'll Learn
- Cancer patients often need hospital admission in acute care settings
- Pain, nausea, and shortness of breath are common reasons for emergency treatment
- Hospital stays can be stressful; have a support person post-discharge
- Chemotherapy may be administered in hospitals or at home
- Nonprofit hospitals must provide charity care to needy patients
Cancer patients often need hospital admission in acute care settings
The use of acute-care hospitals increases in the last months of a patient's life. Cancer patients may be admitted to the hospital for a number of reasons, including complications from cancer and cancer treatment. Many cancer patients experience a decline in physical functioning, including loss of mobility, which can contribute to increased length of stay and readmissions. Additionally, cancer patients are at risk of infection for a few weeks after treatment, and hospital admission is necessary for quick identification and treatment of infections.
The decision to admit a cancer patient to the hospital may also depend on the type of chemotherapy they are receiving and the care and support they require. For example, if a patient is receiving chemotherapy into a vein, they will usually be admitted to the chemotherapy day unit for treatment through a cannula, central line, PICC line, or portacath/port.
While home care services have improved, they are often not able to provide all the required assistance, and hospital admission is sometimes necessary. Cancer patients with complex medical needs may require the specialized care and treatments offered in acute care settings.
Healthcare professionals should recognize that acute admission can be a point of transition for a person living with cancer and take the opportunity to discuss the risk of further admissions and the patient's preferences.
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Pain, nausea, and shortness of breath are common reasons for emergency treatment
Cancer patients have complex medical needs that can sometimes only be managed in hospital settings. Inpatient care is an unavoidable step in the cancer treatment trajectory.
Pain, nausea, and shortness of breath are the most common reasons cancer patients seek emergency treatment. A nationwide analysis found that pain was a problem in 62% of patients, with poorly controlled pain being common in the week before their emergency department visit.
Shortness of breath, or dyspnea, is a common problem for people with cancer. It can be caused by the cancer itself or as a side effect of cancer treatment. This can include surgery, chemotherapy, targeted therapy, immunotherapy, or radiation. It can also be caused by other conditions, such as pain or heart conditions. Shortness of breath can develop over time or come on suddenly. If shortness of breath comes on suddenly, it could be a medical emergency, and emergency services should be contacted.
Nausea can be a side effect of some cancer drug treatments. Chemotherapy can be administered in a hospital or at home, depending on the drugs being administered and the patient's situation. Chemotherapy can affect patients physically and emotionally, and support is available.
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Hospital stays can be stressful; have a support person post-discharge
Hospital stays can be stressful for cancer patients, and inpatient care is often an unavoidable step in the cancer trajectory. Cancer patients have complex and unpredictable medical needs that can only be managed in inpatient services. Chemotherapy, for example, can be administered at home or in the hospital, depending on the drugs being used and the patient's situation. However, hospital stays come with risks such as exposure to infections, sleep deprivation, poor nutrition, and limited mobility, all of which can contribute to post-hospital syndrome, where patients experience a transient state of generalized risk for adverse health events after discharge.
To ensure a smooth transition and reduce the risk of readmission, it is important to have a support person post-discharge. Hospitals often have discharge planners to coordinate the information and care you'll need after leaving. This includes medication reconciliation, planning for homecoming or transfer to another facility, and determining the need for caregiver training or support. You can also involve a family member or friend in the discharge process, ensuring you have a ride home and arranging any extra help you may need.
Additionally, consider the following to make the transition smoother:
- Understand your condition and the next steps in your care, including any medications and their side effects.
- Ask questions and take notes to ensure you have the information you need. Request printed or translated information if necessary.
- Follow your healthcare provider's instructions to minimize the risk of returning to the hospital.
- Be aware of the signs of infection, as cancer patients are more vulnerable to them.
- If transferring to a rehab facility or nursing home, seek advice from a social worker or hire a private geriatric care manager to help choose a suitable facility.
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Chemotherapy may be administered in hospitals or at home
Chemotherapy is a common treatment for cancer that uses drugs to destroy cancer cells and prevent tumour growth. It is usually administered intravenously, but can also be administered orally, intrathecally (into the cerebrospinal fluid via the spinal cord), through injections (subcutaneous or intraperitoneal), or into the bladder (intravesicular instilling). The length of chemotherapy treatment depends on the type of chemotherapy being administered. A treatment session can take anywhere from a few minutes to a few hours, and some people may require a continuous infusion that lasts several days. Chemotherapy is typically an outpatient procedure, meaning that patients can return home on the same day as their treatment.
The location of chemotherapy treatment depends on the type of chemotherapy being administered and the specific needs of the patient. Treatment can take place in hospitals, clinics, infusion centres, a patient's home, or in an oncologist's office. Patients receiving chemotherapy in a hospital will typically do so in a chemotherapy day unit. This unit provides treatment through a drip, which can last anywhere from a few minutes to a few hours. In some cases, patients may require a central line to be placed in their neck or chest for long-term treatment, or a PICC line to be placed in their arm for short-term treatment.
For patients receiving chemotherapy at home, a district nurse can provide support and assistance. Home chemotherapy is typically administered orally or in liquid form. Patients receiving chemotherapy at home may still need to visit a hospital or clinic periodically to ensure that infections are picked up and treated quickly.
While home care services for cancer patients have progressively improved in terms of organisation and population coverage, they are not always able to provide all the required assistance outside of hospitals. Cancer patients frequently require hospital admission, particularly in acute care settings. This is due to the unpredictable and complex medical needs associated with cancer, which may require specialist care that can only be provided in a hospital setting.
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Nonprofit hospitals must provide charity care to needy patients
Cancer patients often require hospital admission in acute care settings. While home care services have improved, they are not always able to provide all the required assistance outside of hospitals. This means that cancer patients frequently need hospital care.
Nonprofit hospitals are required to provide charity care to needy patients. To retain tax-exempt status, nonprofit hospitals must establish a financial assistance policy (FAP). The FAP must outline who is eligible for charity care, the level of assistance provided, and how patients can apply. Hospitals must make their FAP easily accessible and ensure it is translated into the languages commonly spoken in the community. Federal regulations define approaches for calculating the amount billed to patients eligible for charity care, based on Medicare, Medicaid, and commercial plan payment rates.
Nonprofit hospitals are also required to conduct a Community Health Needs Assessment (CHNA) every three years and adopt strategies to address those needs. The CHNA must define the community served by the hospital and evaluate its health needs, integrating input from local stakeholders. Charity care costs represented 1.4% or less of operating expenses at half of all hospitals in 2020, with substantial variation across facilities.
Policy makers are considering reforms to strengthen hospital charity care programs. These include changes to the requirements for nonprofit hospitals to qualify for tax-exempt status, such as providing charity care to patients below a specified income threshold and mandating a minimum amount of community benefits. The establishment of a minimum community benefit threshold is controversial, as there is no conclusive evidence that it increases community benefit investments.
Nonprofit hospitals are often the largest employers in their communities and do not pay state and local taxes. As healthcare costs rise, policymakers are examining the tax benefits received by nonprofit hospitals and the level of charity care provided in return.
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Frequently asked questions
Cancer patients frequently need hospital admission, especially in acute care settings. However, it is not always necessary, and home care services are becoming more common.
Pain, nausea, and shortness of breath are the most common reasons for cancer patients to seek emergency treatment. Other reasons include abdominal pain, pneumonia, and fatigue.
Some patients receive chemotherapy at home, either in the form of tablets or through a pump that constantly administers chemotherapy through the bloodstream. Home care chemotherapy nurses are also available from some hospitals and private healthcare companies.
Hospitals can provide comprehensive care and quickly refer patients to the appropriate department. Hospitals are also better equipped to deal with infections that may arise after cancer treatment.
