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Palliative Care Use in Advanced Cancer in the Garden State
Bridget L Nicholson1, Linda Flynn, Beth Savage
1Author Affiliations: Rutgers School of Nursing, Rutgers, The State University of New Jersey (Drs Nicholson, Flynn, Savage, and Zha); and Rutgers School of Public Health, Rutgers, The State University of New Jersey (Dr Kozlov).
Background:
Cancer is the second leading cause of death in the United States. Patients with metastatic cancer have a high symptom burden. Major global and domestic cancer care recommendations advise integration of palliative care services for these patients. Palliative care is specialized care that can decrease cost, improve symptom burden, and improve quality of life. Patient factors driving the use of palliative care remain poorly understood but may include both physiological and psychological needs, namely, pain and depression, respectively.
Objective:
The objective of this study was to identify patient-level predictors associated with inpatient palliative care use in patients with metastatic cancer.
Methods:
This was a secondary analysis of the 2018 New Jersey State Inpatient Database. The sample was limited to hospitalized adults with metastatic cancer in New Jersey. Descriptive statistics characterized the sample. Generalized linear modeling estimated the effects of pain and depression on the use of inpatient palliative care.
Results:
The sample included 28 697 hospitalizations for patients with metastatic cancer. Within the sample, 4429 (15.4%) included a palliative care consultation. There was a 9.3% documented occurrence of pain and a 10.9% rate of depression. Pain contributed to palliative care use, but depression was not predictive of an inpatient care consultation. Age, income category, and insurance status were significant factors influencing use.
Conclusion:
Understanding demographic and clinical variables relative to palliative care use may help facilitate access to palliative care for adults experiencing metastatic cancer.
Implication For Practice:
Increased screening for pain and depression may expand palliative care use for adults with metastatic cancer receiving inpatient care.
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