Association of patient socioeconomic status with outcomes after palliative treatment for disseminated cancer.

Autor: Maduka RC; Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA.; Yale Cancer Center Advanced Training Program for Physician Scientist, NIH T32 Fellowship, Yale University School of Medicine, New Haven, Connecticut, USA., Canavan ME; Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA.; Cancer Outcomes Public Policy and Effectiveness Research (COPPER) Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA., Walters SL; Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA., Ermer T; Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA.; Faculty of Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.; London School of Hygiene & Tropical Medicine, University of London, London, UK., Zhan PL; Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA., Kaminski MF; Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA., Li AX; Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA., Pichert MD; Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA., Salazar MC; Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA.; National Clinician Scholars Program, Yale University School of Medicine, New Haven, Connecticut, USA., Prsic EH; Palliative Care Program, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA., Boffa DJ; Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2024 May; Vol. 13 (9), pp. e7028.
DOI: 10.1002/cam4.7028
Abstrakt: Background: Palliative treatment has been associated with improved quality of life and survival for a wide variety of metastatic cancers. However, it is unclear whether the benefits of palliative treatment are uniformly experienced across the US cancer population. We evaluated patterns and outcomes of palliative treatment based on socioeconomic, sociodemographic and treating facility characteristics.
Methods: Patients diagnosed between 2008 and 2019 with Stage IV primary cancer of nine organ sites were analyzed in the National Cancer Database. The association between identified variables, and outcomes concerning the administration of palliative treatment were analyzed with multivariable logistic regression and Cox proportional hazard models.
Results: Overall 238,995 (23.6%) of Stage IV patients received palliative treatment, which increased over time for all cancers (from 20.7% in 2008 to 25.6% in 2019). Palliative treatment utilization differed significantly by region (West less than Northeast, OR: 0.55 [0.54-0.56], p < 0.001) and insurance payer status (uninsured greater than private insurance, OR: 1.35 [1.32-1.39], p < 0.001). Black race and Hispanic ethnicity were also associated with lower rates of palliative treatment compared to White and non-Hispanics respectively (OR for Blacks: 0.91 [0.90-0.93], p < 0.001 and OR for Hispanics: 0.79 [0.77-0.81] p < 0.001).
Conclusions: There are important differences in the utilization of palliative treatment across different populations in the United States. A better understanding of variability in palliative treatment use and outcomes may identify opportunities to improve informed decision making and optimize quality of care at the end-of-life.
(© 2024 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje