Disparities in place of death from prostate cancer revealed by disaggregation of Asian race.

Authors

null

Alexandra Noveihed

Robert Wood Johnson Medical School, New Brunswick, NJ

Alexandra Noveihed, Naveena Lall, S. M. Qasim Hussaini, Pei-Lun Kuo, Amanda L. Blackford, Arjun Gupta, Ramy Sedhom

Organizations

Robert Wood Johnson Medical School, New Brunswick, NJ, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, Department of Epidemiology, Johns Hopkins University, Baltimore, MD, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, University of Minnesota Masonic Cancer Center, Minneapolis, MN

Research Funding

No funding received
None.

Background: Place of death (PoD) is a surrogate determinant of health care inequity in patients with cancer. Aggregation of Asian Americans, a diverse group, may mask significant health disparities in end-of-life care. Methods: De-identified death certificate data were obtained via the National Center for Health Statistics. All adult (> 18 years of age) prostate cancer deaths from 2018 to 2019 were included. Multinomial logistic regression was used to test for differences in place of death associated with sociodemographic variables. Results: From 2018 through 2019, 81,292 adults died from prostate cancer. Overall, most Asians were less likely to die at home (p < 0.05) or nursing facility (p < 0.05) compared to White patients. Significant differences in nursing facility use was noted in disaggregated analysis, with Samoan patients 12.44 times more likely to die in a hospice facility compared to hospital (CI 2.89, 53.6; p < 0.001) and Chinese patients 100 times less likely to die in a hospice facility (CI 0.01, 0.02; p < 0.001) to give two notable examples. Chinese (OR 0.26), Guamanian (OR 0.2), and Vietnamese race (OR 0.05) had the lowest likelihood of dying at home, with odds ratio lower than Black race (OR 0.3) (Table). Conclusions: Increased attention to PoD over recent years has highlighted issues around equity in end-of-life care. Overall, our data underscore important differences among Asian subpopulations and possible barriers to quality end of life care that would otherwise be masked with data aggregation. It is well known that resources are needed to allow death at home or at a nursing facility. Further qualitative work is planned to investigate culture differences contributing to PoD differences for patients with cancer through the lens of the social determinants of health.

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Abstract Details

Meeting

2022 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session B

Track

Palliative and Supportive Care,Technology and Innovation in Quality of Care,Quality, Safety, and Implementation Science

Sub Track

End-of-Life Care

Citation

J Clin Oncol 40, 2022 (suppl 28; abstr 187)

DOI

10.1200/JCO.2022.40.28_suppl.187

Abstract #

187

Poster Bd #

A12

Abstract Disclosures

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