End‐of‐life quality metrics among medicare decedents at minority‐serving cancer centers: A retrospective study

Autor: Shama S. Alam, Garrett Wasp, Donald Carmichael, Inas S. Khayal, Gabriel A. Brooks, Amber E. Barnato, Andrea M. Austin, Nirav S. Kapadia
Rok vydání: 2020
Předmět:
Male
0301 basic medicine
Advance care planning
Cancer Research
medicine.medical_specialty
Palliative care
Referral
Life quality
Cancer Care Facilities
Medicare
lcsh:RC254-282
law.invention
03 medical and health sciences
0302 clinical medicine
law
Neoplasms
cancer
Humans
Medicine
Radiology
Nuclear Medicine and imaging
Minority Groups
Original Research
Aged
Quality Indicators
Health Care
Retrospective Studies
end‐of‐life quality
Aged
80 and over
Terminal Care
minority
business.industry
Cancer
Retrospective cohort study
treatment intensity
Emergency department
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
medicine.disease
Intensive care unit
United States
Hospitalization
Benchmarking
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Emergency medicine
Quality of Life
Female
business
Cancer Prevention
Zdroj: Cancer Medicine
Cancer Medicine, Vol 9, Iss 5, Pp 1911-1921 (2020)
ISSN: 2045-7634
DOI: 10.1002/cam4.2752
Popis: Background We calculated the performance of National Cancer Institute (NCI)/National Comprehensive Cancer Network (NCCN) cancer centers’ end‐of‐life (EOL) quality metrics among minority and white decedents to explore center‐attributable sources of EOL disparities. Methods We conducted a retrospective cohort study of Medicare beneficiaries with poor‐prognosis cancers who died between April 1, 2016 and December 31, 2016 and had any inpatient services in the last 6 months of life. We attributed patients’ EOL treatment to the center at which they received the preponderance of EOL inpatient services and calculated eight risk‐adjusted metrics of EOL quality (hospice admission ≤3 days before death; chemotherapy last 14 days of life; ≥2 emergency department (ED) visits; intensive care unit (ICU) admission; or life‐sustaining treatment last 30 days; hospice referral; palliative care; advance care planning last 6 months). We compared performance between patients across and within centers. Results Among 126,434 patients, 10,119 received treatment at one of 54 NCI/NCCN centers. In aggregate, performance was worse among minorities for ED visits (10.3% vs 7.4%, P
We evaluated end‐of‐life quality metrics by minority serving status at NCI/NCCN cancer centers. We found higher minority‐serving status associated with worse end‐of‐life quality on some but not all measures. However, at any given cancer center, care was similar for minority and white patients.
Databáze: OpenAIRE
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