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Social Deprivation and End-of-Life Care Use Among Adults With Cancer.
- Source :
- JCO Oncology Practice; Jan2024, Vol. 20 Issue 1, p102-110, 10p
- Publication Year :
- 2024
-
Abstract
- PURPOSE Socioeconomic differences are partially responsible for racial inequities in cancer outcomes, yet the association of area-level socioeconomic disadvantage and race with end-of-life (EOL) cancer care quality is poorly understood. METHODS This retrospective study used electronic medical records from an academic health system to identify 33,635 adults with cancer who died between 2013 and 2019. Using multivariable logistic regression, we examined associations between decedent characteristics and EOL care, including emergency department (ED) visits, intensive care unit (ICU) stays, palliative care consultation (PCC), hospice order, and in-hospital deaths. Social deprivation index was used to measure socioeconomic disadvantages. RESULTS Racially minoritized decedents had higher odds of ICU stay than the least deprived White decedents (eg, other race Q3: aOR, 2.06 [99% CI, 1.26 to 0.3.39]). White and Black decedents from more deprived areas had lower odds of ED visit (White Q3: aOR, 0.382 [99% CI, 0.263 to 0.556]; Black Q3: aOR, 0.566 [99% CI, 0.373 to 0.858]) than least deprived White decedents. Compared with White decedents living in least deprived areas, racially minoritized decedents had higher odds of receiving PCC and hospice order, whereas White decedents in most deprived areas had lower odds of PCC (aOR, 0.727 [99% CI, 0.592 to 0.893]) and hospice order (aOR, 0.845 [99% CI, 0.724 to 0.986]). Greater deprivation was associated with greater odds of hospital death relative to least deprived White decedents, but only among minoritized decedents (eg, Black Q4: aOR, 2.16 [99% CI, 1.82 to 2.56]). CONCLUSION Area-level socioeconomic disadvantage is not uniformly associated with poorer EOL cancer care, with differences among decedents of different racial groups. [ABSTRACT FROM AUTHOR]
- Subjects :
- INTENSIVE care units
HOSPITALS
MINORITIES
CONFIDENCE intervals
TERMINALLY ill
MULTIVARIATE analysis
BLACK people
HEALTH outcome assessment
RETROSPECTIVE studies
ACQUISITION of data
SOCIAL isolation
CANCER patients
SOCIOECONOMIC factors
RACIAL inequality
PEARSON correlation (Statistics)
RESEARCH funding
MEDICAL records
MEDICAL referrals
CHI-squared test
DESCRIPTIVE statistics
ELECTRONIC health records
LOGISTIC regression analysis
WHITE people
ODDS ratio
DEATH
EMERGENCY room visits
PALLIATIVE treatment
CANCER patient medical care
LONGITUDINAL method
ADULTS
Subjects
Details
- Language :
- English
- ISSN :
- 26881527
- Volume :
- 20
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- JCO Oncology Practice
- Publication Type :
- Academic Journal
- Accession number :
- 174771944
- Full Text :
- https://doi.org/10.1200/OP.23.00420