Team-Based Hospice Referrals: A Potential Quality Metric for Lung Cancer in the Immunotherapy Era.
Thomas W Lycan, Alyssa Buckenheimer, Jimmy Ruiz and 6 others
PMID 35512681WHAT IT FOUND
Patients referred to hospice by their cancer team were less likely to die in hospital or ICU, but survival was similar and hospitalization was higher.
Key findings
01Team-based hospice referral was associated with decreased rates of death in the ICU or hospital.
02Overall survival was similar, but hospitalization was more frequent among patients with team-based hospice referrals.
03Among patients never referred to hospice, half had no documented hospice discussion.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a single-center retrospective study, so it cannot show that team-based hospice referral caused better end-of-life outcomes. The study assumed that hospice enrollment is beneficial, but it also notes that not all patients and families benefit. Hospice and palliative care discussions may have occurred without documentation, especially by providers without formal palliative care training. Other regions may not have the same access to palliative care or hospice. The team-based subgroup was 83 patients, and the never referred group was 45 patients, so estimates may be imprecise. Data were extracted by study team physicians with random sample validation, which may leave extraction errors.
Declared interests
The National Cancer Institute P30CA012197 funded the study. The authors declared no potential conflicts of interest.
The easy way to misread this
Do not conclude that team-based hospice referral makes patients live longer or reduces hospital use. Overall survival was similar, and hospitalization was higher among the team-based referral group.