Oral Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Predictors of unplanned emergency department visits and hospitalisations among adults accessing virtual outpatient oncology services in Queensland, Australia (126337)

Ramya Walsan 1 , Reema Harrison 1 , Jeffrey Braithwaite 1 , Deepak Bhonagiri 2 , Michelle Moscova 3 , Elizabeth Manias 4 , Ashfaq Chauhan 1 , Anita Vandyke 5 , Natalie Taylor 6 , Virginia Mumford 1 , Peprah Peprah 1 , Rebecca Mitchell 1
  1. Macquarie University, Macquarie Park, NSW, Australia
  2. South Western Sydney Local Health District, Campbelltown
  3. Health Answers, Shoalhaven
  4. Monash University, Clayton
  5. NSW Health Infrastructure, Sydney
  6. University of New South Wales, Sydney

Objectives: Virtual care is increasingly utilised in the provision of oncology services, prompting questions about its impact on healthcare outcomes. This study aimed to examine the association between virtual outpatient oncology care and unplanned hospital service utilisation among adults accessing oncology services and to identify sociodemographic and clinical factors that predict these outcomes.


Sample and Setting: A retrospective cohort study was conducted among 39,099 adults with confirmed cancer diagnoses who accessed non admitted patient (NAP) oncology services in Queensland between 1 January 2018 and 31 December 2020 using linked administrative data on unplanned emergency department (ED) visits, all-cause hospitalisations, and cancer-related hospitalisations.


Procedures: Multivariable logistic regression examined associations between NAP virtual care and unplanned hospital service use adjusting for sociodemographic and clinical factors.


Results: Virtual care users had higher odds of unplanned ED visits (OR: 1.64; 95% CI: 1.50–1.79) and all-cause hospitalisations (OR: 1.20; 95% CI: 1.10–1.30), with no association for cancer-related admissions. Presence of Charlson comorbidities, mental health conditions, and digestive or lung cancers (vs breast cancer) were associated with higher odds of unplanned service use. Lower odds of unplanned service use were observed among females, individuals living in the affluent areas, who were treated during lockdown, with poorly differentiated tumours, born outside Australia, and with higher NAP use. Younger age and rural residence were linked to increased likelihood of unplanned ED visits but reduced risk of unplanned all-cause hospitalisations. Being on active treatment predicted unplanned all-cause hospitalisations only.


Conclusion and Clinical Implications: Virtual outpatient oncology care was associated with increased unplanned ED visits and all-cause hospitalisations among cancer patients. This may reflect greater clinical complexity, improved access or precautionary referrals driven by a lower threshold for escalation in cancer. Although virtual care has transformed oncology delivery, greater understanding of its optimal integration to support care delivery is required.