Potentially avoidable emergency department visits among adults with advanced cancer receiving palliative care: frequency, characteristics, and associated factors. A Systematic Review
DOI:
https://doi.org/10.71112/7hq1ky67Keywords:
Palliative care, Advanced cancer, Emergency department, Avoidable visits, End-of-life care, Healthcare utilization, Systematic review.Abstract
Emergency department visits are common among patients with advanced cancer and may increase during the final stages of disease. Although many visits are related to acute complications requiring urgent assessment, others may potentially be managed through anticipatory symptom control, outpatient care, or timely access to palliative care services. This systematic review aimed to determine the frequency of potentially avoidable emergency department visits among adults with advanced cancer receiving palliative care and to describe their clinical characteristics and associated factors. A systematic review was conducted in accordance with PRISMA 2020 recommendations. Original studies involving adults with advanced, terminal, or incurable cancer receiving palliative care were included when they explicitly assessed the avoidability of emergency department visits. Methodological quality was assessed using Joanna Briggs Institute tools according to study design, and a narrative synthesis was performed because of clinical and methodological heterogeneity. Of 500 records initially identified, four studies met the eligibility criteria. The proportion of potentially avoidable emergency department visits ranged from 19% to 51.5%. The most frequent reasons associated with potentially avoidable visits were pain potentially manageable in the outpatient setting, constipation, dehydration, and problems related to medication availability. In contrast, dyspnea, infection, fever, bleeding, and neurological disturbances were more frequently observed among visits considered necessary. Earlier access to palliative care, longer follow-up, home-based care, and the availability of alternatives to hospital-based acute care were also associated with lower emergency department use. However, the lack of a standardized definition of a potentially avoidable visit limited direct comparison across studies. Future research should use reproducible criteria and clearly describe the healthcare context in which avoidability is assessed.
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Copyright (c) 2026 Fabián Patricio Paredes Velasco, Isaac Jessua Castillo Barreno, Abigail Estefanía Quishpe Briones, Byron Andres Chamba Lapo, Patricia Fernanda Galárraga Carrillo (Autor/a)
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