Prevalence, trend and disparities of palliative care utilization among hospitalized metastatic breast cancer patients who received critical care therapies
Background: Early integration of palliative care (PC) for patients with advanced cancer has been recommended to improve quality of care. This study aims to describe prevalence, temporal trend and predictors of PC use in metastatic breast cancer (mBCa) patients receiving critical care therapies (CCT;...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-12-01
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| Series: | Breast |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0960977620302071 |
| _version_ | 1818844515785506816 |
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| author | Ying Chen Shuchen Lin Yihui Zhu Rui Xu Xiaohong Lan Fang Xiang Xiang Li Ye Zhang Shudong Chen Hao Yu Dongni Wu Juxiang Zang Jiali Tang Jiewen Jin Hedong Han Zhonghua Tao Yonggang Zhou Xichun Hu |
| author_facet | Ying Chen Shuchen Lin Yihui Zhu Rui Xu Xiaohong Lan Fang Xiang Xiang Li Ye Zhang Shudong Chen Hao Yu Dongni Wu Juxiang Zang Jiali Tang Jiewen Jin Hedong Han Zhonghua Tao Yonggang Zhou Xichun Hu |
| author_sort | Ying Chen |
| collection | DOAJ |
| description | Background: Early integration of palliative care (PC) for patients with advanced cancer has been recommended to improve quality of care. This study aims to describe prevalence, temporal trend and predictors of PC use in metastatic breast cancer (mBCa) patients receiving critical care therapies (CCT; included invasive mechanic ventilation, percutaneous endoscopic gastrostomy tube, total parenteral nutrition, tracheostomy and dialysis). Methods: The National Inpatient Sample was queried for mBCa patients receiving CCT between 2005 and 2014. Annual percent changes (APC) were calculated for PC prevalence in the overall cohort and subgroups. Multivariable logistic analysis was used to explore predictors of PC use. Results: Of 5833 mBCa patients receiving CCT, 880 (15.09%) received PC. Rate of PC use increased significantly from 2.53% in 2005 to 25.96% in 2014 (APC: 35.75%; p < 0.0001). Higher increase in PC use was observed in South (from 0.65% to 27.11%; APC: 59.42%; p < 0.0001), medium bedsize hospitals (from 3.75% to 26.05%; APC: 38.16%; p = 0.0006) and urban teaching hospitals (from 4.13% to 29.86%; APC: 37.33%; p = 0.0005). Multivariable analysis revealed that year interval, urban teaching hospitals, and invasive mechanical ventilation were associated with increased PC use, while primary diagnosis of gastrointestinal disorders, fractures, metastatic sites from lymph nodes and tracheostomy were associated with lower PC use. Conclusions: PC use in mBCa patients receiving CCT increases significantly over the period. However, it still remains low. Efforts to illustrate disparities in PC use are needed to improve quality of care for mBCa patients receiving CCT, especially for those hospitalized in rural and nonteaching hospitals. |
| first_indexed | 2024-12-19T05:15:00Z |
| format | Article |
| id | doaj.art-646b1a43007e4538b88b9eb8f0049f5f |
| institution | Directory Open Access Journal |
| issn | 1532-3080 |
| language | English |
| last_indexed | 2024-12-19T05:15:00Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Breast |
| spelling | doaj.art-646b1a43007e4538b88b9eb8f0049f5f2022-12-21T20:34:41ZengElsevierBreast1532-30802020-12-0154264271Prevalence, trend and disparities of palliative care utilization among hospitalized metastatic breast cancer patients who received critical care therapiesYing Chen0Shuchen Lin1Yihui Zhu2Rui Xu3Xiaohong Lan4Fang Xiang5Xiang Li6Ye Zhang7Shudong Chen8Hao Yu9Dongni Wu10Juxiang Zang11Jiali Tang12Jiewen Jin13Hedong Han14Zhonghua Tao15Yonggang Zhou16Xichun Hu17Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Department of Pharmacy, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, ChinaDepartment of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaDepartment of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, ChinaDepartment of Pharmacy, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, ChinaDepartment of Pharmacy, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, ChinaDepartment of Pharmacy, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, ChinaDepartment of Pharmacy, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, ChinaDepartment of Pharmacy, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, ChinaDepartment of Pharmacy, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, ChinaDepartment of Pharmacy, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, ChinaDepartment of Pharmacy, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, ChinaDepartment of Pharmacy, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, ChinaDepartment of Pharmacy, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, ChinaDepartment of Endocrinology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, ChinaDepartment of Health Statistics, Second Military Medical University, Shanghai, 200433, ChinaDepartment of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Corresponding author. Department of Medical Oncology, Fudan University Shanghai Cancer Center, No. 270, Dong An Road, Shanghai, 200032, China.Department of Pharmacy, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China; Corresponding author. Department of Pharmacy, Jinling Hospital, School of Medicine, Nanjing University, No.34 Yanggongjing, Nanjing, 210002, China.Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Corresponding author. Department of Medical Oncology, Fudan University Shanghai Cancer Center, No. 270, Dong An Road, Shanghai, 200032, China.Background: Early integration of palliative care (PC) for patients with advanced cancer has been recommended to improve quality of care. This study aims to describe prevalence, temporal trend and predictors of PC use in metastatic breast cancer (mBCa) patients receiving critical care therapies (CCT; included invasive mechanic ventilation, percutaneous endoscopic gastrostomy tube, total parenteral nutrition, tracheostomy and dialysis). Methods: The National Inpatient Sample was queried for mBCa patients receiving CCT between 2005 and 2014. Annual percent changes (APC) were calculated for PC prevalence in the overall cohort and subgroups. Multivariable logistic analysis was used to explore predictors of PC use. Results: Of 5833 mBCa patients receiving CCT, 880 (15.09%) received PC. Rate of PC use increased significantly from 2.53% in 2005 to 25.96% in 2014 (APC: 35.75%; p < 0.0001). Higher increase in PC use was observed in South (from 0.65% to 27.11%; APC: 59.42%; p < 0.0001), medium bedsize hospitals (from 3.75% to 26.05%; APC: 38.16%; p = 0.0006) and urban teaching hospitals (from 4.13% to 29.86%; APC: 37.33%; p = 0.0005). Multivariable analysis revealed that year interval, urban teaching hospitals, and invasive mechanical ventilation were associated with increased PC use, while primary diagnosis of gastrointestinal disorders, fractures, metastatic sites from lymph nodes and tracheostomy were associated with lower PC use. Conclusions: PC use in mBCa patients receiving CCT increases significantly over the period. However, it still remains low. Efforts to illustrate disparities in PC use are needed to improve quality of care for mBCa patients receiving CCT, especially for those hospitalized in rural and nonteaching hospitals.http://www.sciencedirect.com/science/article/pii/S0960977620302071DisparitiesPalliative careMetastatic breast cancerInpatient |
| spellingShingle | Ying Chen Shuchen Lin Yihui Zhu Rui Xu Xiaohong Lan Fang Xiang Xiang Li Ye Zhang Shudong Chen Hao Yu Dongni Wu Juxiang Zang Jiali Tang Jiewen Jin Hedong Han Zhonghua Tao Yonggang Zhou Xichun Hu Prevalence, trend and disparities of palliative care utilization among hospitalized metastatic breast cancer patients who received critical care therapies Breast Disparities Palliative care Metastatic breast cancer Inpatient |
| title | Prevalence, trend and disparities of palliative care utilization among hospitalized metastatic breast cancer patients who received critical care therapies |
| title_full | Prevalence, trend and disparities of palliative care utilization among hospitalized metastatic breast cancer patients who received critical care therapies |
| title_fullStr | Prevalence, trend and disparities of palliative care utilization among hospitalized metastatic breast cancer patients who received critical care therapies |
| title_full_unstemmed | Prevalence, trend and disparities of palliative care utilization among hospitalized metastatic breast cancer patients who received critical care therapies |
| title_short | Prevalence, trend and disparities of palliative care utilization among hospitalized metastatic breast cancer patients who received critical care therapies |
| title_sort | prevalence trend and disparities of palliative care utilization among hospitalized metastatic breast cancer patients who received critical care therapies |
| topic | Disparities Palliative care Metastatic breast cancer Inpatient |
| url | http://www.sciencedirect.com/science/article/pii/S0960977620302071 |
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