UNASSIGNED: 135 Background: CareFirst BCBS initiated a multistate oncology pathway program in 2008, which reduced chemotherapy and hospitalization expenditures and also increased supportive care drug utilization. This study evaluated the impact of following pathways including supportive care versus not following pathways on ER visits/hospitalizations and associated costs as a result of @entity417 , @entity1398 , and @entity1209 ( @entity1209 ). METHODS: The CareFirst claims database was utilized to evaluate data two years after initiation of the pathways program. Frequency of ER visits/hospitalizations for @entity1398 , @entity417 and @entity1209 was the primary outcome measured and was compared between compliant and noncompliant pathway utilization of granulocyte colony-stimulating factors (G-CSFs), erythropoiesis-stimulating agents (ESAs), and antiemetics, respectively. Logistic regression analyses were used to control for expenditures of ESAs, CSFs, and antiemetics in the context of compliance and the corresponding visit types. Costs associated with ER visits/hospitalizations were also compared between compliant and noncompliant pathway utilization of supportive care. RESULTS: Overall, 46 sites with 1,586 @entity1 were evaluated. There were a total of 12 ER visits/hospitalizations for @entity417 , 231 for @entity1398 , and 360 for @entity1209 . @entity1261 pathway compliance resulted in a relative reduction in ER visits/hospitalizations of 67.2% (from 28.3% to 11.5%, p<0.001). Logistic regression showed consistent results when controlling for costs with a 69.5% relative reduction of ER visits/hospitalizations (p<0.001). A comparison of ER visits/hospitalization costs as a result of @entity1398 demonstrated @entity1261 pathway compliance producing an average savings of  1,173 per line of therapy (p=0.001). Analogous analyses did not demonstrate a significant relationship between ESA and antiemetic utilizations and their corresponding ER visits/hospitalizations. CONCLUSIONS: Adherence to oncology pathways, including @entity1261 use rules, is associated with a significantly lower ER visits/hospitalization rates and costs associated with @entity1398 .

The impact of compliance to oncology pathways that include XXXX rules for use on ER visits/hospitalizations in a multistate program.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity417 :: ('MESH:D000740', 'Disease') :: ['anemia'] @entity1261 :: ('1440', 'Gene') :: ['G-CSF'] @entity1398 :: ('MESH:D009503', 'Disease') :: ['neutropenia', 'febrile neutropenia'] @entity1209 :: ('MESH:D020250', 'Disease') :: ['chemotherapy-induced nausea and vomiting', 'CINV']
@entity1261 :: (1440,Gene) :: ['G-CSF']
