Case Study

75 Year Old Patient with Lung Cancer

Specialty Care Management (SCM) Proactively Improves Patient and Health Plan Experience

Upon evaluation for case management, a 75-year-old patient undergoing chemotherapy for lung cancer was found to be suffering from prolonged constipation. Unable to self-administer an enema, the patient had attempted various OTC remedies without relief. Despite being in this condition for eight days, the patient was reluctant to visit the ER due to the cost of his $500 copay and indicated that he would simply wait until his next scheduled oncologist appointment, which was two weeks away.
Thanks to the intervention of SCM, the patient was able to avoid bowel surgery and possible colostomy. Additionally, the patient’s health plan was spared the exorbitant expense of additional hospital days, surgical costs and the potential long-term costs of colostomy supplies, greatly improving the overall experience for all parties involved.
After educating the patient about the potential health risks associated with allowing prolonged constipation to continue, SCM notified and discussed the situation with the patient’s oncologist. The oncology office called him and saw him that day for an unscheduled appointment. He was admitted directly from the oncology office to the hospital, where a partial obstruction was identified and resolved without surgery.
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