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Intersection of Palliative Care and Hospice Use Among Patients With Advanced Lung Cancer
Elizabeth R Hooker1, Joaquin Chapa2, Kelly C Vranas1,2,3
1Center to Improve Veteran Involvement in their Care (CIVIC), VA Portland Health Care System, Portland, Oregon, USA.
Journal of Palliative Medicine
|June 1, 2023
Summary
Palliative care (PC) is linked to higher hospice enrollment in advanced lung cancer patients. However, this association varies by region and care team factors, suggesting regional resource availability impacts end-of-life care choices.
Area of Science:
- Oncology
- Palliative Care
- Health Services Research
Background:
- Hospice and palliative care (PC) are crucial for advanced lung cancer patients.
- Understanding the interplay between PC and hospice is vital for optimizing end-of-life care.
- Previous research indicates benefits but lacks detailed analysis of influencing factors.
Purpose of the Study:
- To investigate the relationship between palliative care (PC) and hospice utilization in advanced lung cancer patients.
- To identify patient, regional, and healthcare team factors influencing this relationship.
- To explore potential substitution effects between PC and hospice.
Main Methods:
- Retrospective cohort study of 22,907 advanced lung cancer patients in the U.S. Veterans Health Administration (2007-2017).
- Utilized mixed logistic regression with random effects, adjusted for patient variables and propensity score weighting.
- Examined variations in PC and hospice use by U.S. region and PC team characteristics.
Main Results:
- 57% received PC, 69% received hospice; 16% received neither. 60% of hospice users also received PC.
- Patients receiving PC had significantly higher odds of hospice enrollment (aOR=3.25).
- Significant regional variations in hospice enrollment probability were observed (e.g., 85% Southeast vs. 73% Northeast). PC team duration, training, and facility complexity influenced hospice use.
Conclusions:
- Palliative care is associated with increased hospice enrollment among advanced lung cancer patients.
- The relationship between PC and hospice is moderated by geographic region and PC team/facility characteristics.
- Findings suggest regional differences in PC resource availability may influence substitution between PC and hospice for end-of-life care.
Keywords:
delivery modelsend of lifehealth services researchlung neoplasmspalliative carepatterns of carequality of lifeMore Related Videos
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