Place of death for patients with cancer in the United States, 1999 through 2015: Racial, age, and geographic disparities

Chino, Fumiko; Kamal, Arif H.; LeBlanc, Thomas W.; Zafar, S. Yousuf; Suneja, Gita; Chino, Junzo

doi:10.1002/cncr.31737

Cited by 53 publications

(46 citation statements)

References 61 publications

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“…We also observed an increase in the proportion of African Americans dying in the hospital over time, which is consistent with other studies of African American patients with malignancy that have higher shown likelihood of dying in acute care setting [11][12][13]. We would however draw caution in interpreting this finding as inferences on race from the National Inpatient Sample is problematic due to a high proportion of patients with "missing" race in earlier years, and that race is variably and inconsistently reported between states.…”

Section: Discussionsupporting

confidence: 91%

Hospitalization at the end of life in patients with multiple myeloma

et al. 2021

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Background Despite advances in treatment, multiple myeloma (MM) remains incurable and results in significant morbidity and mortality. Further research investigating where MM patients die and characterization of end-of-life hospitalizations is needed. Methods We utilized the National Inpatient Sample (NIS) to explore the hospitalization burden of MM patients at the end of their lives. Results The percent of patients dying in the hospital as a percent of overall MM deaths ranged from 54% in 2002 to 41.4% in 2017 (p < 0.01). Blood transfusions were received in 32.7% of these hospitalizations and infections were present in 47.8% of patients. Palliative care and/or hospice consultations ranged from 5.3% in 2002 to 31.4% in 2017 (p < 0.01). Conclusion Our study demonstrates that patients with MM dying in the hospital have a significant requirement for blood transfusions and have a high infection burden. We also show that palliative care and hospice involvement at the end of life has increased over time but remains low, and that ultimately, inpatient mortality has decreased over time, but MM patients die in the hospital at a higher rate than the general population.

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Section: Discussionsupporting

confidence: 91%

Hospitalization at the end of life in patients with multiple myeloma

et al. 2021

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“…After searching almost fourthly-thousand citations, 284 articles were included in our study, of which 147 were manuscripts that directly addressed end-of-life and hospice care, palliative care, as well as advance care planning and directives that include non-Hispanic Blacks. 4 …”

Section: Methodsmentioning

confidence: 99%

Disparities in Palliative and Hospice Care and Completion of Advance Care Planning and Directives Among Non-Hispanic Blacks: A Scoping Review of Recent Literature

Bazargan

Bazargan‐Hejazi

2020

Am J Hosp Palliat Care

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Objectives: Published research in disparities in advance care planning, palliative, and end-of-life care is limited. However, available data points to significant barriers to palliative and end-of-life care among minority adults. The main objective of this scoping review was to summarize the current published research and literature on disparities in palliative and hospice care and completion of advance care planning and directives among non-Hispanc Blacks. Methods: The scoping review method was used because currently published research in disparities in palliative and hospice cares as well as advance care planning are limited. Nine electronic databases and websites were searched to identify English-language peer-reviewed publications published within last 20 years. A total of 147 studies that addressed palliative care, hospice care, and advance care planning and included non-Hispanic Blacks were incorporated in this study. The literature review include manuscripts that discuss the intersection of social determinants of health and end-of-life care for non-Hispanic Blacks. We examined the potential role and impact of several factors, including knowledge regarding palliative and hospice care; healthcare literacy; communication with providers and family; perceived or experienced discrimination with healthcare systems; mistrust in healthcare providers; health care coverage, religious-related activities and beliefs on palliative and hospice care utilization and completion of advance directives among non-Hispanic Blacks. Discussion: Cross-sectional and longitudinal national surveys, as well as local community- and clinic-based data, unequivocally point to major disparities in palliative and hospice care in the United States. Results suggest that national and community-based, multi-faceted, multi-disciplinary, theoretical-based, resourceful, culturally-sensitive interventions are urgently needed. A number of practical investigational interventions are offered. Additionally, we identify several research questions which need to be addressed in future research.

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“…Our analysis also compared ESLD with other major causes of death and found that although ESLD had the second highest proportion of deaths in hospice, it still substantially trailed malignancy. Based on previous studies in cancer populations, ( 29,44,45 ) we expected and found that patients who died with HCC and non‐HCC malignancy had significantly higher rates of death at hospice and home than other diseases. Death attributed to infection, on the other hand, occurred more often in an inpatient setting, which may be because infections are felt by many to require hospitalization.…”

Section: Discussionmentioning

confidence: 98%

“…These trends have been reflected in other studies, including in patients with Medicare insurance, ( 26 ) chronic lung disease, ( 27 ) dementia, ( 28 ) and malignancy. ( 29 ) Although it is difficult to attribute these changing patterns to a particular intervention or policy change, there has been a progressive move in the United States toward the expansion of hospice services in an effort to decrease health care costs and improve quality of life. ( 30,31 )…”

Section: Discussionmentioning

confidence: 99%

National Trends in Location of Death in Patients With End‐Stage Liver Disease

et al. 2021

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Despite improvement in the care of patients with end‐stage liver disease (ESLD), mortality is rising. In the United States, patients are increasingly choosing to die at hospice and home, but data in patients with ESLD are lacking. Therefore, this study aimed to describe the trends in location of death in patients with ESLD. We conducted a retrospective cross‐sectional analysis using the Centers for Disease Control and Prevention Wide‐Ranging OnLine Data for Epidemiologic Research from 2003 to 2018. Death location was categorized as hospice, home, inpatient facility, nursing home, or other. Comparisons were made between sex, age, ethnicity, race, region, and other causes of death. Comparisons were also made between rates of change (calculated as annual percent change), proportion of deaths in 2018, and multivariable logistic regression. A total of 535,261 deaths were attributed to ESLD—most were male, non‐Hispanic, and White. The proportion of deaths at hospice and home increased during the study period from 0.2% to 10.6% and 20.3% to 25.7%, respectively. Whites had the highest proportion of deaths in hospice and home. In multivariable analysis, elderly patients were more likely to die in hospice or home (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.07‐1.35), whereas Black patients were less likely (OR, 0.58; 95% CI, 0.46‐0.73). Compared with other causes of death, ESLD had the second highest proportion of deaths in hospice but lagged behind non–hepatocellular carcinoma malignancy. Deaths in patients with ESLD are increasingly common at hospice and home overall, and although the rates have been increasing among Black patients, they are still less likely to die at hospice or home. Efforts to improve this disparity, promote end‐of‐life care planning, and enhance access to death at hospice and home are needed.

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Place of death for patients with cancer in the United States, 1999 through 2015: Racial, age, and geographic disparities

Cited by 53 publications

References 61 publications

Hospitalization at the end of life in patients with multiple myeloma

Hospitalization at the end of life in patients with multiple myeloma

Disparities in Palliative and Hospice Care and Completion of Advance Care Planning and Directives Among Non-Hispanic Blacks: A Scoping Review of Recent Literature

National Trends in Location of Death in Patients With End‐Stage Liver Disease

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