Potentially Avoidable Admissions and Emergency Department Visits Among Patients Receiving Outpatient Chemotherapy

Identifying Attributes

Care Settings
Care Transitions
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Prospective Payment System (PPS) - Exempt Cancer Hospital Quality Reporting Program
Type of Quality Indicator
Outcome
IOM Quality Dimension
Effectiveness
Domain
Hospitalisation

Defining Attributes

Definition

Percentage of cancer patients 18 years of age or older receiving outpatient chemotherapy who have an admission or emergency department (ED) visit for nausea, emesis, anaemia, neutropenic fever, diarrhoea, dehydration, or pain.

Numerator

Cancer patients 18 years of age or older undergoing outpatient chemotherapy treatment who were admitted to an inpatient setting or ED with one of the following principal diagnoses during the course of treatment: Nausea Emesis Anaemia Neutropenic fever Diarrhoea Dehydration Pain Two rates are reported for this measure: 1) Percent of patients admitted to the ED 2) Percent of patients admitted to the inpatient hospital setting

Denominator

Patients aged 18 years and older as of the start of the measurement period with a principal diagnosis of cancer who received at least one outpatient chemotherapy treatment at the reporting facility during the intake period.

Exclusions

Patients with hematologic cancer during the intake period. Patients receiving inpatient chemotherapy during the intake period.

Use of Risk Adjustment
No
Risk Adjustments

None

Stratifications

Collection and Reporting Attributes

Type of Data Collection
Administrative data
Data Collection Methods

Claims data

Frequency of Data Collection
Annually
Frequency of Data Collection in Days
365
Reporting Methods

Prospective Payment System-Exempt Cancer Hospital Quality Reporting Program (CMS and Providers)

Reporting Frequency
Annually
Reporting Frequency in Days
365
Indicator Has Recommended Targets
No

Source and Reference Attributes

Evidence Source

Gidwani-Marszowski, R., Faricy-Anderson, K., Asch, S.M., Illarmo, S., Ananth, L. and Patel, M.I. (2020), Potentially avoidable hospitalizations after chemotherapy: Differences across medicare and the Veterans Health Administration. Cancer, 126: 3297-3302. doi.org/10.1002/cncr.32896

Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
No
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
No
Australian Consortium for Aged Care Endorsed
No
Can the Quality Indicator be Readily Implemented at a Population Level in Australia Given its Current Data Landscape?
Implementation of this quality indicator was not assessed.
Identified by PHARMA-Care Project
No
Upload Date
31 March 2026