Characteristics of Hospitalized Cancer Patients Referred for Inpatient Palliative Care Consultation

Area of Science:

• Oncology
• Palliative Care
• Health Services Research

Background:

• Palliative care is linked to better patient/family outcomes and reduced healthcare costs.
• Less than 50% of appropriate hospitalized adults in the U.S. receive palliative care.
• Limited research exists on factors influencing palliative care receipt in hospitalized patients.

Purpose of the Study:

• To identify characteristics of hospitalized advanced cancer patients associated with palliative care referral.
• To understand factors influencing access to interdisciplinary hospital-based palliative care teams for advanced cancer patients.

Main Methods:

• Prospective observational study involving 3096 hospitalized advanced cancer patients across five hospitals.
• Multivariable logistic regression analysis used to determine associations between patient characteristics and palliative care referral.
• Data collected on patient demographics, clinical factors, symptom burden, and functional needs at admission.

Main Results:

• Only 19% of advanced cancer patients were referred to palliative care; 81% received usual care.
• Patients needing assistance with transfers or taking medication for pain, nausea, or constipation were more likely to be referred.
• Higher comorbidity counts and greater symptom burden at admission significantly increased the likelihood of palliative care referral.

Conclusions:

• Advanced cancer patients with high symptom burden at hospital admission are more likely to receive palliative care consultation.
• A significant minority of advanced cancer patients are referred to palliative care, highlighting a potential gap in care.
• Standardized screening for palliative care is recommended to ensure equitable access to evidence-based care for advanced cancer patients.