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Hospice utilization in patients with malignant gliomas
Deborah Forst1,2, Eric Adams1, Ryan Nipp2
1Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts.
Neuro-Oncology
|October 19, 2017
Summary
Hospice care enrollment and length of stay varied significantly among patients with malignant glioma, highlighting disparities by race, sex, age, education, and residence. Further research is needed to address these barriers to early hospice utilization.
Area of Science:
- Oncology
- Palliative Care
- Health Services Research
Background:
- Limited research exists on end-of-life (EOL) practices for malignant glioma (MG) patients.
- Professional organizations recommend early hospice enrollment for cancer patients.
Purpose of the Study:
- To evaluate hospice enrollment rates and length of stay (LOS) among patients with MG.
- To identify factors associated with hospice enrollment and LOS in this population.
Main Methods:
- Utilized the SEER-Medicare-linked database for adult MG patients diagnosed 2002-2011 and deceased by 2012.
- Employed logistic regression analyses to determine predictors of hospice enrollment and longer LOS.
Main Results:
- 63% of 12,437 eligible MG patients enrolled in hospice.
- Older age, female sex, higher education, white race, and lower income predicted hospice enrollment.
- Median LOS was 21 days; older age, female sex, and urban residence predicted longer LOS.
Conclusions:
- Significant disparities in hospice utilization exist for MG patients based on sociodemographic factors.
- Barriers to earlier and broader hospice access require further investigation.
