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- Title
The Determinants of Palliative Care Use in Patients With Colorectal Cancer: A National Study.
- Authors
Colibaseanu, Dorin T.; Osagiede, Osayande; Spaulding, Aaron C.; Frank, Ryan D.; Merchea, Amit; Mathis, Kellie L.; Parker, Alexander S.; Ailawadhi, Sikander
- Abstract
Background: Palliative care is associated with improved survival and quality of life, but its use among patients with colorectal cancer varies nationwide and the determinants of those variations are not clear. Objective: To determine the factors associated with palliative care use among patients who died of colorectal cancer. Methods: Deceased patients treated for colorectal cancer (2004-2013) were identified within the National Cancer Database. Multivariable logistic regression was used to evaluate patient and institutional characteristics associated with palliative care use. Patients were classified based on their length of survival (<6 months, 6-24 months, and 24+ months) to provide timing context. Results: A total of 287 923 patients were analyzed. Overall, 4.3% of the patients received palliative care. Patients who received palliative care were more likely to be younger, recently diagnosed, treated at academic hospitals, and have stage IV disease. Patients living in Mountain and Pacific regions had higher odds of palliative care receipt than those in the East Coast. Patients without insurance had higher odds of palliative care if they survived <24 months. Insurance coverage through Medicaid was associated with increased palliative care use among patients who survived 6 to 24 months. Patients who survived <6 months and lived >9 miles from the institution received more palliative care. Conclusion: Palliative care use among patients with colorectal cancer is associated with a younger age, a more recent year of diagnosis, insurance status, academic hospitals, and living in Mountain and Pacific regions.
- Subjects
UNITED States; CANCER patients; CANCER treatment; CHI-squared test; COLON tumors; REPORTING of diseases; HEALTH insurance; LONGITUDINAL method; MEDICAL care use; PALLIATIVE treatment; PROBABILITY theory; RECTUM tumors; RESEARCH funding; SURVIVAL analysis (Biometry); TERMINALLY ill; MULTIPLE regression analysis; SOCIOECONOMIC factors; SPECIALTY hospitals; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; ODDS ratio
- Publication
American Journal of Hospice & Palliative Medicine, 2018, Vol 35, Issue 10, p1295
- ISSN
1049-9091
- Publication type
Article
- DOI
10.1177/1049909118765092