Intersection of Palliative Care and Hospice Use Among Patients With Advanced Lung Cancer.
J Palliat Med
; 26(11): 1474-1481, 2023 11.
Article
de En
| MEDLINE
| ID: mdl-37262128
ABSTRACT
Background:
Hospice and palliative care (PC) are important components of lung cancer care and independently provide benefits to patients and their families.Objective:
To better understand the relationship between hospice and PC and factors that influence this relationship.Methods:
A retrospective cohort study of patients diagnosed with advanced lung cancer (stage IIIB/IV) within the U.S. Veterans Health Administration (VA) from 2007 to 2013 with follow-up through 2017 (n = 22,907). Mixed logistic regression models with a random effect for site, adjustment for patient variables, and propensity score weighting were used to examine whether the association between PC and hospice use varied by U.S. region and PC team characteristics.Results:
Overall, 57% of patients with lung cancer received PC, 69% received hospice, and 16% received neither. Of those who received hospice, 60% were already enrolled in PC. Patients who received PC had higher odds of hospice enrollment than patients who did not receive PC (adjusted odds ratio = 3.25, 95% confidence interval 2.43-4.36). There were regional differences among patients who received PC; the predicted probability of hospice enrollment was 85% and 73% in the Southeast and Northeast, respectively. PC team and facility characteristics influenced hospice use in addition to PC; teams with the shortest duration of existence, with formal team training, and at lower hospital complexity were more likely to use hospice (all p < 0.05).Conclusions:
Among patients with advanced lung cancer, PC was associated with hospice enrollment. However, this relationship varied by geographic region, and PC team and facility characteristics. Our findings suggest that regional PC resource availability may contribute to substitution effects between PC and hospice for end-of-life care.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Accompagnement de la fin de la vie
/
Établissements de soins palliatifs
/
Tumeurs du poumon
Type d'étude:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Patient_preference
Limites:
Humans
Langue:
En
Journal:
J Palliat Med
Sujet du journal:
SERVICOS DE SAUDE
Année:
2023
Type de document:
Article
Pays d'affiliation:
États-Unis d'Amérique