Race/Ethnicity and County-Level Social Vulnerability Impact Hospice Utilization Among Patients Undergoing Cancer Surgery
Autor: | J. Madison Hyer, Alizeh Abbas, Timothy M. Pawlik |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Race ethnicity Palliative care business.industry MEDLINE Ethnic group Logistic regression 03 medical and health sciences 0302 clinical medicine Oncology Surgical oncology Interquartile range 030220 oncology & carcinogenesis Internal medicine medicine 030211 gastroenterology & hepatology Surgery business Social vulnerability |
Zdroj: | Annals of Surgical Oncology. 28:1918-1926 |
ISSN: | 1534-4681 1068-9265 |
Popis: | Integration of palliative care services into the surgical treatment plan is important for holistic patient care. We sought to examine the association between patient race/ethnicity and county-level vulnerability relative to patterns of hospice utilization. Medicare Standard Analytic Files were used to identify patients undergoing lung, esophageal, pancreatic, colon, or rectal cancer surgery between 2013 and 2017. Data were merged with the Centers for Disease Control and Prevention’s social vulnerability index (SVI). Logistic regression was utilized to identify factors associated with overall hospice utilization among deceased individuals. A total of 54,256 Medicare beneficiaries underwent lung (n = 16,645, 30.7%), esophageal (n = 1427, 2.6%), pancreatic (n = 6183, 11.4%), colon (n = 26,827, 49.4%), or rectal (n = 3174, 5.9%) cancer resection. Median patient age was 76 years (IQR 71–82 years), and 28,887 patients (53.2%) were male; the majority of individuals were White (91.1%, n = 49,443), while a smaller subset was Black or Latino (racial/ethnic minority: n = 4813, 8.9%). Overall, 35,416 (65.3%) patients utilized hospice services prior to death. Median SVI was 52.8 [interquartile range (IQR) 30.3–71.2]. White patients were more likely to utilize hospice care compared with minority patients (OR 1.24, 95% CI 1.17–1.31, p |
Databáze: | OpenAIRE |
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