Subpar Use of Hospice, Imaging in End-of-Life Cancer Care
The researchers found that among 6568 commercially insured patients, 56.3% were hospitalized and 48.6% underwent one or more imaging scans in the last month of life.
(HealthDay News) — About half of cancer patients are hospitalized and undergo at least one imaging scan at the end of life, according to a study published online in the Journal of Oncology Practice.
Cara L. McDermott, PharmD, PhD, from the Fred Hutchinson Cancer Research Center in Seattle, and colleagues linked insurance claims to clinical information to examine indicators of high-quality end-of-life care. Patients aged ≥18 years with an invasive solid tumor with a recorded death date, who were enrolled in a commercial plan for the last month of life, and who made at least one insurance claim in the last 90 days of life were enrolled.
The researchers found that among 6568 commercially insured patients, 56.3% were hospitalized and 48.6% underwent one or more imaging scans in the last month of life. Overall, 31.4% of patients younger than 65 years were enrolled in hospice; 40.5% of those not enrolled in hospice had received an opioid prescription. Among young adults not enrolled in hospice, opioid use in the last 30 days of life decreased over time, from 44.7% in 2007 to 2009 to 42.5% in 2010 to 2012, and to 36.7% in 2013 to 2015.
"Our findings suggest that policies that facilitate appropriate imaging, opioid, and hospice use and that encourage supportive care may improve end-of-life care and quality of life," the authors write.
One author disclosed financial ties to the pharmaceutical industry, and second author disclosed ties to a company that provides virtual care.
- McDermott CL, Fedorenko C, Kreizenbeck K, et al. End-of-Life Services Among Patients With Cancer: Evidence From Cancer Registry Records Linked With Commercial Health Insurance Claims. J Oncol Pract. 19 July 2017. doi: 10.1200/JOP.2017.021683