Patterns of Palliative Care Consultation Among Elderly Patients With Cancer
| Autor: | Daniel P. Triplett, Loren K. Mell, Rayna K. Matsuno, Isabel J. Boero, Eric Roeland, Lindsay Hwang, James D. Murphy, Heidi N. Yeung |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Metastatic breast medicine.medical_specialty Palliative care Population Specialty MEDLINE Medicare 03 medical and health sciences 0302 clinical medicine Neoplasms Acute care medicine Humans 030212 general & internal medicine Practice Patterns Physicians' education Referral and Consultation Aged Aged 80 and over education.field_of_study business.industry Palliative Care Age Factors Cancer Retrospective cohort study medicine.disease United States Oncology 030220 oncology & carcinogenesis Family medicine Emergency medicine Female business SEER Program |
| Zdroj: | Journal of the National Comprehensive Cancer Network. 14:439-445 |
| ISSN: | 1540-1413 1540-1405 |
| DOI: | 10.6004/jnccn.2016.0050 |
| Popis: | Background The role of palliative care has expanded over the past several decades, although the oncology-specific regional evolution of this specialty has not been characterized at the population-based level. Methods This study defined the patterns of palliative care delivery using a retrospective cohort of patients with advanced cancer within the SEER-Medicare linked database. We identified 83,022 patients with metastatic breast, prostate, lung, and colorectal cancers. We studied trends between 2000 through 2009, and determined patient-level and regional-level predictors of palliative care delivery. Results Palliative care consultation rates increased from 3.0% in 2000 to 12.9% in 2009, with most consultations occurring in the last 4 weeks of life (77%) in the inpatient hospital setting. The rates of palliative care delivery were highest in the West (7.6%) and lowest in the South (3.2%). The likelihood of palliative care consultation increased with decreasing numbers of regional acute care hospital beds per capita. The use of palliative care consultation increased with increasing numbers of regional physicians. The use of palliative care decreased with increasing regional Medicare expenditure with a $1,387 difference per beneficiary between the first and fourth quartiles of palliative care use. Conclusions Geographic location influences a patient's options for palliative care in the United States. Although the overall rates of palliative care are increasing, future effort should focus on improving palliative care services in regions with the least access. |
| Databáze: | OpenAIRE |
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