High-Intensity End-of-Life Care Among Patients With GI Cancer in Puerto Rico: A Population-Based Study

Ortiz‐Ortiz, Karen J.; Tortolero‐Luna, Guillermo; Torres‐Cintrón, Carlos R.; Zavala-Zegarra, Diego E.; Gierbolini-Bermúdez, Axel; Ramos-Fernández, María

doi:10.1200/op.20.00541

Cited by 7 publications

(2 citation statements)

References 50 publications

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“…The PRCCR maintains up-to-date information through linkages with other databases, such as death certificates and health insurance claims databases. Since 2008, cancer cases have been linked to the health insurance claims files (HILD), containing information for nearly 90.0% of Puerto Rico cancer cases [ 13 ]. Endometrial cancer cases were obtained from the PRCCR-HILD, which has met the completeness and data quality standards [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

Sociodemographic, clinical characteristics, and treatment patterns of endometrial cancer cases in Puerto Rico during the period 2009 to 2015: A retrospective study

Pagán Santana,

Castañeda Ávila,

Ríos Motta

et al. 2024

PLoS ONE

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Background Over the past decades, the rising incidence rates of endometrial cancer have made it a significant public health concern for women worldwide. Treatment strategies for endometrial cancer vary based on several factors such as stage, histology, the patient’s overall health, and preferences. However, limited amount of research on treatment patterns and potential correlations with sociodemographic characteristics among Hispanics is available. This study analyzes the treatment patterns for patients diagnosed with endometrial cancer in Puerto Rico. Methods A secondary database analysis was performed on endometrial cancer cases reported to the Puerto Rico Central Cancer Registry-Health Insurance Linkage Database from 2009 to 2015 (n = 2,488). The study population’s sociodemographic and clinical characteristics were described, along with an overview of the therapy options provided to patients receiving care on the island. Logistic regression models were used to evaluate the association of sociodemographic/clinical characteristics with treatment patterns stratified by risk of recurrence. Results In our cohort, most patients were insured through Medicaid and had a median age of 60 years. Almost 90% of patients received surgery as the first course of treatment. Surgery alone was the most common treatment for low-risk patients (80.2%). High-risk patients were more likely to receive surgery with radiotherapy and chemotherapy (24.4%). Patients with Medicare insurance were five times (HR: 4.84; 95% CI: 2.45–9.58; p < 0.001) more likely to receive surgery when compared with patients insured with Medicaid. In contrast, those with private insurance were twice as likely to receive surgery (HR: 2.38; 95% CI: 1.40–4.04; p = 0.001) when compared to those with Medicaid. Conclusion These findings provide insight into the treatment patterns for endometrial cancer in Puerto Rico and highlight the importance of considering factors such as disease risk when making treatment decisions. Addressing these gaps in treatment patterns can contribute to effective management of endometrial cancer.

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Section: Methodsmentioning

confidence: 99%

Sociodemographic, clinical characteristics, and treatment patterns of endometrial cancer cases in Puerto Rico during the period 2009 to 2015: A retrospective study

Pagán Santana,

Castañeda Ávila,

Ríos Motta

et al. 2024

PLoS ONE

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“…While hospice is available in Puerto Rico, patients with advanced cancer commonly visit the ED at EoL. 8,9 These visits are associated with poor symptom control or aggressive care. 8,10 Identification of these patients and their palliative care or hospice needs can help in care coordination.…”

Section: Introductionmentioning

confidence: 99%

Patterns of End-of-Life Care as Measured by Emergency Room Visits Among Cancer Patients in Puerto Rico

Ramos-Fernández

Ortiz‐Ortiz

Torres‐Cintrón

et al. 2021

Am J Hosp Palliat Care

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Background: Community palliative care (PC) services are scarce in Puerto Rico (PR). Patients with advanced cancer commonly visit the emergency department(ED) at the end of life (EoL). Recognition of patients with limited life expectancies and PC needs may improve the EoL trajectory of these patients. Our objective was to characterize ED visits of cancer patients at the EoL by examining the patterns of ED visits in PR using the PR Central Cancer Registry-Health Insurance Linkage Database (PRCCR-HILD). Methods: The cohort consisted of patients aged ≥18 years with a primary invasive that died between 2011- 2017, with a recorded date of death, and who had insurance claims during their last three months. EoL indicators were ED visits, ED death, and hospice care use. Results: The study cohort included 10,755 cancer patients. 49.6% had ≥1 ED visit, 20.3% had ≥2 ED visits, and 9.7% died in the ED. In the adjusted model, female patients (aOR 0.80; 95% CI 0.68-0.93; p-value < 0.01), patients aged ≥80 years (aOR 0.47; 95% CI 0.36-0.63; p-value < 0.01), being enrolled in Medicare (aOR 0.74; 95% CI 0.61-0.90; p-value < 0.01) or being enrolled in Medicaid/Medicare (aOR 0.76; 95% CI 0.62-0.93; p-value = 0.01) were less likely to have an ED visit the date of death. Patients with distant stage are more likely to have ED ≥ 2visits ( p-value < 0.05). Conclusions: ED visits at EoL can be interpreted as poor quality cancer care and awareness of the potential of ED-initiated PC is needed in PR.

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Functional impairment is associated with medical debt in male cancer survivors and credit card debt in female cancer survivors

Grafova,

Manne,

Hudson

et al. 2023

Support Care Cancer

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High-Intensity End-of-Life Care Among Patients With GI Cancer in Puerto Rico: A Population-Based Study

Cited by 7 publications

References 50 publications

Sociodemographic, clinical characteristics, and treatment patterns of endometrial cancer cases in Puerto Rico during the period 2009 to 2015: A retrospective study

Sociodemographic, clinical characteristics, and treatment patterns of endometrial cancer cases in Puerto Rico during the period 2009 to 2015: A retrospective study

Patterns of End-of-Life Care as Measured by Emergency Room Visits Among Cancer Patients in Puerto Rico

Functional impairment is associated with medical debt in male cancer survivors and credit card debt in female cancer survivors

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