Shifting US location patterns in leukaemia mortality: retrospective analysis

Area of Science:

• Hematology
• Palliative Care
• Public Health

Background:

• Leukaemia is a deadly hematological malignancy with significant mortality.
• Understanding end-of-life care patterns is crucial for improving patient outcomes.
• Existing research on end-of-life care for leukaemia patients is limited.

Purpose of the Study:

• To analyze trends in the place of death for leukaemia patients.
• To assess demographic disparities in end-of-life care utilization among leukaemia decedents.
• To identify areas for improvement in palliative care access.

Main Methods:

• Retrospective observational study using national mortality databases (2008-2020).
• Analysis of leukaemia deaths identified from death certificates.
• Categorization of place of death (hospice, home, inpatient, nursing home, outpatient/ER) and statistical analysis of trends and demographic associations.

Main Results:

• A significant shift in leukaemia deaths from inpatient settings (51% to 37%) to home (26% to 40%) and hospice (5% to 9%) was observed.
• Younger adults predominantly died in hospitals, while older adults showed increased home and hospice deaths.
• Racial disparities were noted, with minority groups less likely to receive hospice care and more likely to die in hospitals compared to non-Hispanic whites.

Conclusions:

• Leukaemia end-of-life care is increasingly provided at home or in hospice, aligning with broader palliative care trends.
• Persistent racial disparities in access to hospice and home-based palliative care necessitate targeted interventions.
• Efforts are needed to ensure equitable access to quality end-of-life care for all leukaemia patients.