Resource Utilization in Hospitalized Patients With Cancer From Hospice Decision to Discharge and Provider-Type...

Area of Science:

• Oncology
• Palliative Care
• Healthcare Quality

Background:

• Aggressive resource utilization in end-of-life cancer care is linked to adverse patient and family outcomes.
• Quality end-of-life care metrics are crucial but understudied, particularly concerning provider type.

Purpose of the Study:

• To characterize resource utilization as a proxy for end-of-life care quality.
• To compare care provided by physician and advanced practice provider (APP) teams in hospitalized cancer patients awaiting hospice discharge.

Main Methods:

• Retrospective cohort study at Memorial Sloan Kettering Cancer Center.
• Examined resource utilization and end-of-life quality metrics from hospice decision to discharge.
• Compared patients managed by APP teams versus house staff teams.

Main Results:

• Patients under APP care were less likely to receive laboratory testing (50% vs. 59%, P = .046).
• APP teams performed similarly on end-of-life quality metrics compared to house staff teams.
• Fewer laboratory tests were administered to patients under APP care.

Conclusions:

• Advanced practice providers (APPs) may enhance end-of-life care quality by potentially reducing aggressive interventions.
• APP-managed care suggests a model for high-quality, resource-conscious end-of-life care in oncology.
• Findings indicate APPs' role in optimizing care transitions to hospice.