Preventable emergency department visits and admissions for patients on chemotherapy including oral chemotherapy

e18736 Background: OP-35 is a CMS quality metric used to quantify ED visits and admissions for 10 preventable conditions in the 30 days after chemotherapy. While CMS limited this metric to IV chemotherapy, oral chemotherapy (OC) also poses risk of significant adverse effects. This study aimed to compare the rates of ED visits and admissions between patients on IV chemotherapy, OC, or both. Methods: This single center retrospective analysis included patients with cancer receiving outpatient chemotherapy and those who visited the ED within 30 days of receiving chemotherapy between 1/2019-12/2022. OC broadly included cytotoxic, targeted, and hormonal therapies. The primary outcome was the proportion of ED visits and admissions for preventable diagnoses, as defined by OP-35, between patients receiving IV chemotherapy, OC, or both. T-tests were used to compare continuous variables with a p-value < 0.05 considered statistically significant. Results: Of the patients receiving OC, 15% were on a cytotoxic therapy, 26% were on a targeted therapy, 53% were on a hormonal therapy, and 6% were on multiple agents. Among all patients on chemotherapy, 24% visited the ED within 30 days of treatment. 53% of patients on IV chemotherapy visited the ED, compared to 9% of patients on OC and 9% of patients on both IV and oral treatment (p < 0.001). 45% of patients on IV chemotherapy were admitted, compared to 7% of patients on OC and 7% of patients on both IV and oral treatment (p < 0.001). However, there was no significant difference in rates of ED visits (p = 0.19) or admissions (p = 0.12) for preventable (OP-35) diagnoses between patients on IV chemotherapy, OC, or both, with close to a third of ED visits and admissions being preventable in each group (Table 1). Conclusions: Despite concerns over the vulnerability of patients on OC, in this single center study patients on OC were less likely than patients on IV chemotherapy to visit the ED or require admission, with similar rates of preventable visits. Future analyses will stratify results by class of OC to assess for any differences. While OC may not produce similar rates of acute care visits as IV chemotherapy, approximately one-third could be preventable and may be improved by similar interventions as those targeting patients on IV chemotherapy. [Table: see text]