Abstract PO3-10-04: Palliative Care, Healthcare Utilization, and Disparities in Deceased Breast Cancer Patients in U.S. Hospitals: Analysis of National Inpatient Sample
Authors: Rushin Patel, Zalak Patel, Mrunal Patel, Darshil Patel, Afoma Onyechi, Akshit Chitkara, Femina Patel
Journal: Cancer Research (2024)

Abstract Objective: This study aims to explore the characteristics of receiving palliative care and the patterns of utilization among breast cancer patients using a large-scale representative population-based sample. Methods: A retrospective analysis was performed on hospitalization data obtained from the National Inpatient Sample (NIS) covering the period from January 2016 to December 2019. The objective of the study was to investigate the characteristics and disparities associated with the provision of palliative care to breast cancer patients who had passed away, and to evaluate its impact on healthcare utilization as indicated by discounted hospital charges and length of stay (LOS). To achieve this, multivariate linear and logistic regression analyses were conducted, with the data stratified according to age, race, Charlson comorbidity index, insurance status, patient's zip code, and hospital characteristics. The classification and identification of the study population were performed using ICD-10 codes. Results: In the study, a total of 6,325 deceased breast cancer patients were identified from hospitalization records. Among them, 59.16% (n=3,742) received palliative care during their hospital stay. Multivariate linear regression analysis revealed that patients who received palliative care experienced a significant reduction in LOS by an average of 0.67 days (-1.246 to -0.898, p = 0.02) compared to those who did not receive palliative care. Furthermore, the palliative care group exhibited lower total charges, with a mean decrease of $21,392 (-28205 to -14578, p=0.00) compared to the non-palliative care group. Multivariate logistic regression analysis indicated that patients with black race had lower odds of receiving palliative care, while those with higher household income and patients admitted to larger hospitals had higher odds of receiving palliative care. Additionally, patients with private insurance had a higher probability of receiving palliative care compared to other insurance groups. Conclusion: Palliative care has demonstrated its benefits in reducing healthcare utilization costs and length of stay for breast cancer patients. However, disparities exist in access to palliative care, particularly among Black patients and those with lower household income. Larger hospitals and patients with private insurance show higher rates of palliative care utilization. Addressing these disparities is crucial to ensure equitable access, optimize patient outcomes, and improve resource allocation. Integrating palliative care into breast cancer hospitalizations requires targeted interventions. Further research and implementation efforts are needed to enhance the availability and delivery of palliative care services for all patients, regardless of their demographics or socioeconomic backgrounds. Health policymakers should consider these findings in their resource allocation decisions as palliative care plays an increasingly important role in cancer treatment. Odds of Receiving Palliative care among deceased breast cancer patients XX XX Length Of Stay and Total Charges XX XX Citation Format: Rushin Patel, Zalak Patel, Mrunal Patel, Darshil Patel, Afoma Onyechi, Akshit Chitkara, Femina Patel. Palliative Care, Healthcare Utilization, and Disparities in Deceased Breast Cancer Patients in U.S. Hospitals: Analysis of National Inpatient Sample [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-10-04.