Abstract C41: Palliative care consults in terminal cancer patients dying in a safety-net hospital: Are they underutilized?

Abstract

Abstract Introduction: Terminal patients with limited resources are more likely to die in the hospital which may be due in part to lack of access to palliative care. We hypothesized that the majority of terminal cancer patients who were treated and who died in a safety-net hospital did not receive a palliative care consult. Methods: A retrospective review of terminal cancer patients who were admitted and died at Lyndon Baines Johnson General Hospital, a safety-net hospital, from January through December 2012 was completed. Terminal cancer was defined as Stage IV or recurrent cancer with only palliative treatment options. Data was gathered on age, race/ethnicity, sex, length of stay (LOS) of final admission, underlying terminal cancer, insurance status, and receipt of a palliative consult. Univariate analysis was performed using chi-square and Kruskal-Wallis test. Results: Seventy-four patients with terminal cancer died in the hospital. The majority of patients were minorities: African Americans (n=28, 38%), Hispanics (n=27, 36%), Caucasians (n=14, 19%), and Asian/other ethnicities (n=5, 7%). Two-thirds of patients (n=49, 66%) received palliative consults. There was no difference in race/ethnicity, gender, or age between patients who did and did not receive palliative consults. Patients who received a palliative consult were more likely to be uninsured (90% vs. 56%, p=0.003). There was no difference in median LOS (interquartile range, days) of the final admission between patients who did and did not receive a palliative consult (7, 3-16 versus 6, 2-15 days; p=0.47). Conclusions: In a safety-net hospital, in-hospital deaths still occur among terminal cancer patients even when palliative care consults are received. Further studies are necessary to determine how palliative care can best address the needs of vulnerable patients in order to reduce in-hospital deaths and improve patient-centered outcomes. Citation Format: Rebecca L. Wiatrek, Zeinab I. Alawadi, Debbie F. Lew, Melanie E. Zuo, Jeanette G. Ferrer, Tien C. Ko, Lillian S. Kao, Curtis J. Wray. Palliative care consults in terminal cancer patients dying in a safety-net hospital: Are they underutilized?. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr C41. doi:10.1158/1538-7755.DISP13-C41