Differences in the utilization of palliative care support services among patients with metastatic solid tumor cancer in a community oncology setting: A retrospective review.

Authors

null

Chloe Weidenbaum

University of Tennessee Health Science Center, Nashville, TN

Chloe Weidenbaum, Larry Edward Bilbrey, Natalie R. Dickson, Stephen Matthew Schleicher, Leah Owens, L. Johnetta Blakely, Susan A Frailley, Melissa Scalise, Lee S. Cantrell, Sandhya Mudumbi

Organizations

University of Tennessee Health Science Center, Nashville, TN, Tennessee Oncology PLLC., Nashville, TN, Tennessee Oncology, Nashville, TN, Vanderbilt University Department of Biochemistry, Nashville, TN

Research Funding

No funding received
None.

Background: Palliative care has been underutilized in the setting of advanced cancer despite its established benefit in improving the quality of life in cancer patients. Few studies have evaluated socioeconomic disparities in receiving palliative care in the outpatient oncology setting. We aimed to evaluate for disparities in utilization of palliative care among patients with metastatic solid tumor malignancies at Tennessee Oncology, a large outpatient community oncology practice with an established palliative care program. Methods: We completed a retrospective review of medical records of 1513 patients that were seen in Tennessee Oncology clinics from 12/2020 to 12/2021. We compared the baseline characteristics of patients with metastatic solid tumor malignancies who did and did not receive palliative care. Chi-square and two-sample t-tests were used for data analysis with the 5% significance level using R statistical software. Results: Male patients utilized palliative care less often than female patients (17% versus 24% for females, p =.0002; 95% CI,.05-1.0). Of payer types, Medicare had the least palliative care utilization (14%) compared to commercial (25%) and other payers (23%). Utilization also varied by cancer type, with melanoma (9%), lung cancer (15%) and renal cancer (21%) being least likely to receive palliative care (p <.00005; 95% CI,.19-1.0). We did examine racial differences in palliative care utilization, but those did not reach statistical significance. Conclusions: There are multiple disparities in the utilization of on-site palliative care support services among patients with metastatic solid tumor cancer in this outpatient community oncology setting. Further research is needed to gain insight into why this is, including an in-depth analysis of both patient and provider utilization/referral practices.

Utilization of palliative care by sex, insurance payer type, race, and cancer type.


Palliative care
No palliative care
P value
Sex




p =.0002
Female
24% (n = 208)
76% (n = 659)
Male
17% (n = 108)
83% (n = 527)
Payer type






p =.00005
Commercial
25% (n = 219)
75% (n = 658)
Medicare
14% (n = 70)
86% (n = 428)
Other
23% (n = 18)
77% (n = 59)
Race




p = 0.30
Black
18% (n = 24)
82% (n = 111)
White
22% (n = 283)
78% (n = 1004)
Cancer type


p < 0.00005
Breast
28% (n = 101)
72% (n = 261)
p < 0.00005
Hepatobiliary
37% (n = 16)
63% (n = 27)
p = 0.09
Lung
15% (n = 18)
85% (n = 99)
p < 0.00005
Melanoma
9% (n = 9)
91% (n = 89)
p < 0.00005
Ovarian
28% (n = 11)
72% (n = 29)
p < 0.00005
Pancreatic
48% (n = 78)
52% (n = 85)
p = 0.70
Renal
21% (n = 31)
79% (n = 118)
p < 0.00005

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Abstract Details

Meeting

2022 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session A

Track

Cost, Value, and Policy,Health Care Access, Equity, and Disparities,Patient Experience

Sub Track

Access to and Utilization of Palliative and Supportive Care

Citation

J Clin Oncol 40, 2022 (suppl 28; abstr 82)

DOI

10.1200/JCO.2022.40.28_suppl.082

Abstract #

82

Poster Bd #

C15

Abstract Disclosures