New Study Finds Underutilization of Early Palliative Care for Patients with Advanced Cancer Mostly Attributable to Provider and Organizational Characteristics

Newswise — A new study led by researchers at the American Cancer Society (ACS) shows despite considerable growth in early palliative care (PC) use, utilization among patients with advanced cancer remained low from 2010 to 2019. The findings will be presented at this year’s annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago, May 31-June 4, 2024.

Early integration of palliative care is recommended for advanced-stage cancers, but evidence of its use and the role of provider and organizational characteristics in its uptake is limited. To address this gap, researchers, led by Dr. Xin Hu, a visiting scientist with the American Cancer Society, identified patients 65.5 years old and older, newly diagnosed with advanced breast, colorectal, non-small cell lung, small cell lung, pancreas, and prostate cancers in 2010-2019 who survived at least six months from the linked SEER-Medicare data. Early PC was defined as receipt of PC within 90 days post-diagnosis and before hospice admission, if any. Treating physicians and corresponding organizations were based on patients’ visits surrounding diagnosis. Researchers described the percent of patients receiving early PC each year. Generalized linear models with physician- and organization-fixed effects evaluated variation in early PC receipt between and within physicians/organizations. 

The results showed among 103,045 patients treated by 25,736 unique providers from 11,163 organizations, the percent receiving early PC increased from 0.98% in 2010 to 10.64% in 2019. After adjusting for patients’ characteristics, variation in early PC use between treating providers and organizations explained 47.9% and 31.2% of the total variation, respectively. 

Study authors stress the large variation between providers and organizations suggest important modifiable provider behaviors and organizational characteristics in early PC receipt, which warrant future research to inform interventions to improve uptake of early PC.

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