75-year-old male patient with lung cancer receiving chemotherapy was evaluated for case management. Upon evaluation, it was identified that he had been constipated for 8 days. He had taken OTC remedies without relief and increased fruits and juices for assistance. He was unable to self-administer an enema. He wanted to wait until his next scheduled apt to discuss this with his oncologist. The apt was 2 weeks away. Despite education and encouragement, he was reluctant to go to the ER since there was a co pay of $500 for each ER/hospital admission. He was also reluctant to notify his oncologist. CM notified and discussed the situation with his oncologist. The oncology office called him and saw him that day for an unscheduled appointment. He was admitted from the office to the hospital. At the hospital, a partial obstruction was identified and was resolved without surgery.
This intervention saved the patient bowel surgery and possible colostomy. Also saved his insurance additional hospital days, surgical costs and possibly long term costs of colostomy supplies.