Hospice Referral in Advanced Cancer in New Jersey.
Bridget L Nicholson, Linda Flynn, Beth Savage and 2 others
PMID 35486912WHAT IT FOUND
In New Jersey hospitalizations for metastatic cancer, only 11.4% were referred to hospice.
Black, Hispanic, non-English-speaking, Medicaid or private payer patients were less likely to be referred, while pain and depression were linked with higher referral.
Key findings
01Of 28 697 hospitalizations for metastatic cancer, 3279 (11.4%) had a hospice referral at discharge.
02Compared with White patients, Black patients had lower odds of hospice referral (0.86) and Hispanic patients had lower odds (0.84); patients with a primary language other than English also had lower odds (0.85).
03Patients without a pain diagnosis had lower odds of hospice referral (0.44), and patients without a depression diagnosis had lower odds (0.85).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The data were hospital billing records from New Jersey only, so the findings may not apply to other regions. Hospice referral meant discharge with intent to start hospice; it did not show whether patients received hospice care or declined it after discharge. Pain and depression were captured by ICD-10-CM codes, which may miss symptoms that were present but not coded. The study could not account for oncologist hesitancy, patient readiness, disease treatment, response to therapy, or previous palliative care. The analysis could not examine provider or institution-specific hospice referral policies.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read these associations as proof that pain, depression, race, language, payer or age cause hospice referral. The study used hospital billing records and only recorded discharge to hospice, not whether patients accepted or received hospice care.