Inpatient and Outpatient Palliative Care Utilization Rates of Patients With Spine Metastases

Area of Science:

• Oncology
• Palliative Care
• Health Services Research

Background:

• Specialty Palliative Care (PC) improves quality of life for patients with spine metastasis.
• Equitable access to PC is crucial, yet disparities in utilization are understudied.
• No prior research has examined sociodemographic and treatment factors influencing PC use in spine metastasis.

Purpose of the Study:

• To assess the utilization of inpatient PC (IPPC) and outpatient PC (OPPC) in patients with spine metastases.
• To identify sociodemographic and treatment factors associated with IPPC and OPPC utilization.
• To analyze the impact of PC utilization on survival outcomes in this patient population.

Main Methods:

• Retrospective review of 265 patients with spine metastases treated between February 2018 and February 2020.
• Comparison of characteristics and outcomes between patients who utilized IPPC/OPPC and those who did not.
• Statistical analyses to identify factors associated with PC consultation.

Main Results:

• No significant differences in IPPC/OPPC rates were observed across gender or race.
• Outpatient PC utilization varied significantly with insurance status (P=0.056) and primary tumor type (P=0.025).
• Patients undergoing surgery or radiation therapy within 30 days of BSMTB presentation showed higher OPPC utilization (P=0.0032 and P=0.040, respectively).
• Inpatient PC consults were associated with worse median survival (6.5 vs. 24.2 months), while outpatient PC showed a smaller survival disadvantage (11.2 vs. 19.2 months).

Conclusions:

• PC utilization in spine metastasis patients differs based on insurance and primary tumor type.
• Surgical or radiation treatment for spine metastases correlates with increased outpatient PC consultation.
• Further research is needed to understand PC utilization trends and enhance PC accessibility.