Preferred and Actual Location of Death in Adolescents and Young Adults With Cancer
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View abstract on PubMed
Summary
This summary is machine-generated.Many adolescent and young adult cancer patients die in hospitals, not their preferred location. Over a quarter of those wanting to die at home did not achieve this goal, highlighting a need for better end-of-life care planning.
Area Of Science
- Oncology
- Palliative Care
- Health Services Research
Background
- Adolescent and young adult (AYA) patients with advanced cancer often experience end-of-life care in hospital settings.
- Data on the alignment between AYA patients' end-of-life care preferences and actual outcomes are limited.
Purpose Of The Study
- To assess the concordance between preferred and actual place of death for AYA cancer patients.
- To identify disparities in achieving goal-concordant end-of-life care among AYA cancer patients.
Main Methods
- Multicenter retrospective cohort study of AYA patients (12-39 years) with cancer who died between 2003-2019.
- Analysis of medical records for documented discussions on preferred death location, actual death location, and concordance.
- Data from Dana-Farber Cancer Institute and Kaiser Permanente health systems.
Main Results
- Of 1929 AYA decedents, 63.6% had documented discussions about preferred death location.
- Among those with preferences, 32.8% desired to die at home, 14.4% in a hospital, and 3.9% in inpatient hospice.
- Overall concordance was 75.9%; however, only 70.7% of patients preferring home death achieved it, and 33.3% of those preferring inpatient hospice did so.
Conclusions
- While many AYA cancer patients die in their preferred location, a significant proportion, particularly those preferring home death, do not achieve this goal.
- Findings underscore the critical need for improved strategies to ensure goal-concordant end-of-life care for AYA cancer patients.
- Addressing these care gaps is essential for improving the quality of life and death for this vulnerable population.
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