Abstract:
BACKGROUND:The authors' goal was to characterize hospice enrollment and aggressiveness of care for pancreatic cancer patients at the end of life. METHODS:Surveillance, Epidemiology, and End Results and linked Medicare claims data (1992-2006) were used to identify patients with pancreatic cancer who had died (n = 22,818). The authors evaluated hospice use, hospice enrollment ≥ 4 weeks before death, and aggressiveness of care as measured by receipt of chemotherapy, acute care hospitalization, and intensive care unit (ICU) admission in the last month of life. RESULTS:Overall, 56.9% of patients enrolled in hospice, and 35.9% of hospice users enrolled for 4 weeks or more. Hospice use increased from 36.2% in 1992-1994 to 67.2% in 2004-2006 (P < .0001). Admission to the ICU and receipt of chemotherapy in the last month of life increased from 15.5% to 19.6% (P < .0001) and from 8.1% to 16.4% (P < .0001), respectively. Among patients with locoregional disease, those who underwent resection were less likely to enroll in hospice before death and much less likely to enroll early. They were also more likely to receive chemotherapy (14% vs 9%, P < .0001), be admitted to an acute care hospital (61% vs 53%, P < .0001), and be admitted to an ICU (27% vs 15%, P < .0001) in the last month of life. CONCLUSIONS:Although hospice use increased over time, there was a simultaneous decrease in early enrollment and increase in aggressive care at the end of life for patients with pancreatic cancer.
journal_name
Cancerjournal_title
Cancerauthors
Sheffield KM,Boyd CA,Benarroch-Gampel J,Kuo YF,Cooksley CD,Riall TSdoi
10.1002/cncr.26115subject
Has Abstractpub_date
2011-11-01 00:00:00pages
5003-12issue
21eissn
0008-543Xissn
1097-0142journal_volume
117pub_type
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