Early Palliative Care Is Associated With Reduced Emergency Department Utilization in Pancreatic Cancer

Area of Science:

• Oncology
• Palliative Care
• Health Services Research

Background:

• Pancreatic cancer patients often experience high symptom burden and poor prognoses.
• Palliative care (PC) can enhance quality of life through expert symptom management.
• The optimal timing for initiating PC referrals in pancreatic cancer remains unclear.

Purpose of the Study:

• To investigate the association between early palliative care and healthcare utilization and costs in pancreatic cancer patients.
• To determine if early PC referrals impact emergency department visits and intensive care unit admissions.
• To analyze the financial implications of early versus late palliative care initiation.

Main Methods:

• Retrospective analysis of the SEER-Medicare database (2000-2009).
• Inclusion of pancreatic cancer patients with at least one PC encounter.
• Definition of 'early PC' as referral within 30 days of diagnosis.

Main Results:

• Patients receiving early PC had significantly fewer emergency department (ED) visits (2.6 vs. 3.0) and lower ED care charges ($3158 vs. $3981).
• Early PC was associated with reduced intensive care unit (ICU) admissions (0.82 vs. 0.98) and lower ICU care charges ($14,466 vs. $18,687).
• Multivariable analysis confirmed early PC's association with fewer ED visits and lower ED-related costs.

Conclusions:

• Early palliative care referrals are linked to decreased healthcare utilization, specifically fewer ED visits and lower associated costs.
• These findings support current oncology guidelines recommending early PC for patients with advanced cancers like pancreatic cancer.
• Timely palliative care integration can optimize resource allocation and potentially improve patient care experiences.