Xibei Liu1, Jay J Shen2, Pearl Kim2, Sun Jung Kim3, Johnson Ukken4, Younseon Choi5, In Choel Hwang6, Jae-Hoon Lee7, Sung-Youn Chun2, Jinwook Hwang2, Haneul Choi8, Hyeyoung Yeom2, Yong-Jae Lee9, Ji Won Yoo10. 1. Department of Medicine, University of Arizona College of Medicine, Tuscon, AZ, USA. 2. Department of Healthcare Administration and Policy, University of Nevada, Las Vegas, Las Vegas, NV, USA. 3. Department of Health Administration and Management, Soon Chun Hyang University, Asan, Chungcheongnam-do, Korea. 4. University of Nevada Reno School of Medicine, Reno, NV, USA. 5. Department of Family Medicine, Korea University of College of Medicine, Seoul, Korea. 6. Department of Family Medicine, Gachon University College of Medicine, Inchon, Korea. 7. Department of Family Medicine, University of Nevada, Las Vegas. 8. Honors College, University of Nevada Las Vegas, Las Vegas, NV, USA. 9. Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea. 10. Department of Internal Medicine, University of Nevada Las Vegas School of Medicine, Las Vegas, NV, USA.
Abstract
AIM: Pancreas cancer continues to carry a poor prognosis. Hospitalized patients with advanced chronic pancreatic illnesses increasingly receive palliative care due to its perceived clinical benefits. Meanwhile, a growing proportion of elderly patients are reportedly receiving life-sustaining procedures. Temporal trends in the utilization of life-sustaining procedures and palliative care consultation among dying patients with advanced chronic pancreatic illnesses in US hospitals were examined. METHODS AND MATERIALS: A serial, cross-sectional analysis was carried out using the National Inpatient Sample Database. Decedents 18 years and older with a principal diagnosis of pancreas cancer or other advanced chronic pancreatic illnesses from 2005 through 2014. The compound annual growth rates (CAGRs) and Cochrane-Armitage correction of χ2 statistic were used. The receipt of life-sustaining systemic procedures, intra-abdominal local procedures and surgeries, and palliative care consultation were examined. Multilevel multivariate logistic regressions were performed to examine the association of various procedures with the utilization of palliative care consultation. RESULTS: Among 77 394 183 hospitalizations, 29 515 patients were examined. The CAGRs of systemic procedures, intra-abdominal procedures, surgeries, and palliative care were -4.19% (P = .008), 2.17%, -1.40%, and 14.03% (P < .001), respectively. The receipt of systemic procedures (odds ratio [OR] = 2.40, 95% confidence interval [CI], 2.08-2.74), local intra-abdominal procedures (OR = 1.46, 95% CI, 1.27-1.70), and surgeries (OR = 2.51, 95% CI, 2.07-3.05) was associated with palliative care consultation (Ps < .001). CONCLUSIONS: Among adults with pancreatic cancer or other advanced chronic pancreatic illnesses in the US hospitals from 2005 to 2014, the utilization of life-sustaining systemic procedures decreased while the prevalence of palliative care consultation increased.
AIM: Pancreas cancer continues to carry a poor prognosis. Hospitalized patients with advanced chronic pancreatic illnesses increasingly receive palliative care due to its perceived clinical benefits. Meanwhile, a growing proportion of elderly patients are reportedly receiving life-sustaining procedures. Temporal trends in the utilization of life-sustaining procedures and palliative care consultation among dying patients with advanced chronic pancreatic illnesses in US hospitals were examined. METHODS AND MATERIALS: A serial, cross-sectional analysis was carried out using the National Inpatient Sample Database. Decedents 18 years and older with a principal diagnosis of pancreas cancer or other advanced chronic pancreatic illnesses from 2005 through 2014. The compound annual growth rates (CAGRs) and Cochrane-Armitage correction of χ2 statistic were used. The receipt of life-sustaining systemic procedures, intra-abdominal local procedures and surgeries, and palliative care consultation were examined. Multilevel multivariate logistic regressions were performed to examine the association of various procedures with the utilization of palliative care consultation. RESULTS: Among 77 394 183 hospitalizations, 29 515 patients were examined. The CAGRs of systemic procedures, intra-abdominal procedures, surgeries, and palliative care were -4.19% (P = .008), 2.17%, -1.40%, and 14.03% (P < .001), respectively. The receipt of systemic procedures (odds ratio [OR] = 2.40, 95% confidence interval [CI], 2.08-2.74), local intra-abdominal procedures (OR = 1.46, 95% CI, 1.27-1.70), and surgeries (OR = 2.51, 95% CI, 2.07-3.05) was associated with palliative care consultation (Ps < .001). CONCLUSIONS: Among adults with pancreatic cancer or other advanced chronic pancreatic illnesses in the US hospitals from 2005 to 2014, the utilization of life-sustaining systemic procedures decreased while the prevalence of palliative care consultation increased.
Entities:
Keywords:
health policy; hospital; palliative care; pancreas; time series analysis
Authors: Moon Kyung Joo; Jay J Shen; Ji Won Yoo; Zahra Mojtahedi; Pearl Kim; Jinwook Hwang; Ja Seol Koo; Hee-Taik Kang Journal: BMC Health Serv Res Date: 2022-01-04 Impact factor: 2.655
Authors: Zahra Mojtahedi; Ja Seol Koo; Ji Yoo; Pearl Kim; Hee-Taik Kang; Jinwook Hwang; Moon Kyung Joo; Jay J Shen Journal: Cancer Manag Res Date: 2021-10-02 Impact factor: 3.989