INTRODUCTION: Studies suggest that many emergency department (ED) visits and hospitalizations for cancer patients may be preventable. CMS has implemented changes to the hospital outpatient reporting program that targets acute care in treatment patients for preventable conditions. Oncology urgent care centers aim to streamline patient care. Our cancer center developed an urgent care center called the direct referral unit (DRU) in 2011.

METHODS AND MATERIALS: We abstracted visits to our adjacent hospital ED and DRU from January 2014-June 2018. Patient demographics, cancer and visit diagnoses, visit charges, and 30-day therapy utilization were assessed.

RESULTS: An analysis of 13,114 visits demonstrated that increased DRU utilization was associated with decreased monthly ED visits (p<.001). Common DRU visit diagnoses were dehydration, nausea/vomiting, abdominal pain, and fever. Patients receiving active cancer treatment more frequently presented to the DRU (p<.0001). The average charges were $2,221 for the DRU and $10,261 for the ED.

CONCLUSION: The association of decreased ED visits with increased DRU utilization demonstrates the potential for urgent care centers to reduce acute care visits. Many patients presented to the DRU with preventable conditions. DRU visits were associated with considerable cost savings, supporting its use as a cost-effective method to reduce acute care.

Original languageEnglish
Article numberpkae009
JournalJNCI Cancer Spectrum
Issue number2
Early online dateJan 20 2024
StatePublished - Apr 1 2024


  • Aged
  • Ambulatory Care Facilities
  • Costs and Cost Analysis
  • Emergency Service, Hospital
  • Humans
  • Medicare
  • Neoplasms/epidemiology
  • Patient Acceptance of Health Care
  • United States


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