Emergency Department Visits and Hospital Admissions for Urban and Rural Cancer Patients Receiving Chemotherapy in Colorado, Minnesota, and South Carolina

Date of Conferral



Doctor of Healthcare Administration (D.H.A.)


Health Services


Miriam Ross


Approximately 18 million people in the United States are living with some form of cancer, and many are unable to obtain chemotherapy treatment from specialists due to socioeconomic challenges. The purpose of this quantitative cross-sectional study was to determine if there were statistical differences in the dependent variables of unplanned emergency department (ED) visit rates and inpatient admissions during 2021 for cancer patients receiving outpatient chemotherapy by location (urban versus rural areas) of Colorado, Minnesota, and South Carolina. The conceptual framework used to explore this topic was the health belief model. 2021 secondary data were acquired from the Centers for Medicare and Medicaid database and included all rural and urban hospitals across 50 states. For this study, three states were considered, which included patients from 544 hospitals. Independent samples t-tests were used to test hypotheses. Results indicated there was no statistically significant differences of either dependent variable by location; thus, null hypotheses for both research questions were retained. One potential avenue for further research includes exploration of incidence of unplanned ED visits that lead to inpatient admissions across various geographical areas by using hospital-derived data. Implications for positive social change include results serving as a motivator for healthcare leaders to examine healthcare delivery and innovative modalities in their organization and work toward minimizing patient care delays, unnecessary ED visits, and increased admission rates.

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