| Title |
Determinants and Outcomes of Hospice Utilization Among Patients with Advance-Staged Hepatocellular Carcinoma in a Veteran Affairs Population
|
|---|---|
| Published in |
Digestive Diseases and Sciences, March 2018
|
| DOI | 10.1007/s10620-018-4989-4 |
| Pubmed ID | |
| Authors |
Winnie Y. Zou, Hashem B. El-Serag, Yvonne H. Sada, Sarah L. Temple, Shubhada Sansgiry, Fasiha Kanwal, Jessica A. Davila |
| Abstract |
Hospice provides integrative palliative care for advance-staged hepatocellular carcinoma (HCC) patients, but hospice utilization in HCC patients in the USA is not clearly understood. We examined hospice use and subsequent clinical course in advance-staged HCC patients. We conducted a retrospective study on a national, Veterans Affairs cohort with stage C or D HCC. We evaluated demographics, clinical factors, treatment, and clinical course in relation to hospice use. We identified 814 patients with advanced HCC, of whom 597 (73.3%) used hospice. Oncologist management consistently predicted hospice use, irrespective of HCC treatment [no treatment: OR 2.25 (1.18-4.3), treatment: OR 1.80 (1.10-2.95)]. Among patients who received HCC treatment, hospice users were less likely to have insurance beyond VA benefits (47.2 vs. 60.0%, p = 0.01). Among patients without HCC treatment, hospice users were older (62.2 [17.2] vs. 60.2 [14.0] years, p = 0.05), white (62.1 vs. 52.9%, p = 0.01), resided in the Southern USA (39.5 vs. 31.8%, p = 0.05), and had a performance score ≥ 3 (41.9 vs. 31.8%, p = 0.01). The median time from hospice entry to death or end of study was 1.05 [2.96] months for stage C and 0.53 [1.18] months for stage D patients. 26.7% advance-staged HCC patients never entered hospice, representing potential missed opportunities for improving end-of-life care. Age, race, location, performance, insurance, and managing specialty can predict hospice use. Differences in managing specialty and short-term hospice use suggest that interventions to optimize early palliative care are necessary. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 30 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 30 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 4 | 13% |
| Student > Master | 4 | 13% |
| Researcher | 3 | 10% |
| Lecturer | 2 | 7% |
| Student > Bachelor | 2 | 7% |
| Other | 4 | 13% |
| Unknown | 11 | 37% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 8 | 27% |
| Nursing and Health Professions | 6 | 20% |
| Economics, Econometrics and Finance | 1 | 3% |
| Business, Management and Accounting | 1 | 3% |
| Social Sciences | 1 | 3% |
| Other | 1 | 3% |
| Unknown | 12 | 40% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 May 2018.
All research outputs
#21,358,731
of 23,854,458 outputs
Outputs from Digestive Diseases and Sciences
#3,790
of 4,304 outputs
Outputs of similar age
#296,963
of 334,969 outputs
Outputs of similar age from Digestive Diseases and Sciences
#82
of 85 outputs
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