Palliative care as a component of high-value and cost-saving care during hospitalization for metastatic cancer.

• DOI: 10.1200/jco.2023.41.16_suppl.6640
• Publication Date: 2023-06-04T16:01:03Z
• Authors: Sifan Lu; Eileen Rakovitch; Breffni Hannon; Camilla Zimmermann; Michael Yan; John R de Almeida; Christopher Yao; Erin F. Gillespie; Fumiko Chino; Divya Yerramilli; Fadwa Abdel-Rahman; Hiba Othman; Sara Mheid; Chiaojung Jillian...
• Keywords: Receipt; Odds

6640 Background: Randomized controlled trials have demonstrated that palliative care can improve both quality of life and survival for outpatients with advanced cancer, but there is limited population-based data on the value inpatient care. We assessed as a component high-value among nationally representative sample inpatients metastatic cancer. further identified care, patient, hospital characteristics significantly associated high costs. Methods: This study analyzed hospitalizations patients ≥18 years primary diagnosis cancer from National Inpatient Sample (covering 97% U.S. population) 2010-2019. utilized multivariable mixed-effects logistic regression to assess medical services (receipt invasive ventilation [IMV], systemic therapy), patient demographics, were higher charges billed insurance generalized linear models determine cost savings provision Results: Among 397,691 2010 2019, median charge per admission increased by 24.9%, $44,904 in $56,098 while remained stable at $14,300. Receipt was lower (Odds Ratio [OR], 0.62; 95% CI, 0.61-0.64; P < .001) costs (OR, 0.59; 95%CI, 0.58-0.61; .001). Factors receipt (P or therapy .001), Hispanic young age (18-49 years, For-profit hospitals more likely bill 5.05; 4.78-5.33, less incur 0.51; 0.48-0.54, than public hospitals. In adjusted mixed effects regression, $1,293 (-13.4%, reduction hospitalization compared no independent age. Significant interactions observed between group (-9.6% 18-49 years; -14.7% ≥70 years), IMV (-6.4% receipt; -14.0% IMV), ownership (-19.6% for-profit; -10.5% public), year (-15.4% 2010; -8.9% 2019). Conclusions: reduced irrespective aggressive interventions. Assuming increases 50%, we estimate $4,045,000 annual national savings. Integration may de-escalate incurred through low-value