Atrium Health Wake Forest Baptist, Winston Salem, NC
Tiffany M. Statler , Emily Van Meter Dressler , Heidi D. Klepin , Kathryn E. Weaver , Jennifer Gabbard
Background: The American Society of Clinical Oncology recommends integration of palliative care in patients with advanced cancer. Studies have shown the availability of palliative care services, especially in outpatient settings, varies widely across practice sites; factors associated with outpatient palliative care clinic availability remain unknown. Our study describes the presence and characteristics of palliative care resources in community oncology practices. Methods: Analyses used data from the 2015 Cancer Care Delivery Research (CCDR) Landscape Assessment of National Cancer Institute Community Oncology Research Program (NCORP) practices (funding support provided by 2UG1CA189824). Oncology practices were surveyed regarding availability of specialty providers and supportive services, including palliative care, as reported by designated CCDR leads. Descriptive statistics describe availability of providers and services, and logistic regression models identify practice characteristics associated with supportive/palliative care specialist availability. Results: 216 non-pediatric exclusive NCORP practice groups were included in analyses. Characteristics are shown in Table. A majority of practices had palliative care specialists (76%), oncology certified nurses (95%), and advance practice providers (80%); 45% had nurse navigators for oncology. 76% of practices had inpatient palliative care consultation services, but only 36% had a dedicated outpatient palliative care clinic. Multivariable analyses demonstrated practices with Medicaid and/or uninsured patient volumes > 25% (Odds Ratio (OR) = 2.5, p = 0.020), more oncology providers (OR = 1.02, p = 0.025), survivorship clinic availability (OR = 2.5, p = 0.005), and who participated in the Quality Oncology Practice Initiative (QOPI) (OR = 2.0, p = 0.039) were significantly more likely to have an outpatient palliative care clinic. Conclusions: Most community oncology practices reported having palliative care specialists, although only a third had a dedicated outpatient palliative care clinic. Newly discovered factors associated with increased odds of having an outpatient palliative care clinic can inform future efforts to expand the availability of outpatient palliative care clinics within community oncology practices.
N = 216 (%) | |
---|---|
Number of adult oncology providers*, median (IQR) | 9 (4-18) |
Practice ownership type: Independently owned Owned by large regional/multistate health system Other (HMO/payer, publicly or university owned) | 56 (26%) 141 (67%) 7 (7%) |
Proportion with Medicaid and/or Uninsured populations >25% | 41 (20%) |
Safety-net hospital | 39 (18%) |
Availability of palliative care specialists who see oncology patients at/affiliated with site | 162 (76%) |
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2023 ASCO Annual Meeting
First Author: Tiffany M. Statler
2024 ASCO Quality Care Symposium
First Author: Min Woo Hwang
2020 ASCO Virtual Scientific Program
First Author: Garrett Young
2023 ASCO Breakthrough
First Author: Le Thi Cuc