SUPC-03 UTILIZATION PATTERNS OF PALLIATIVE CARE USE IN PATIENTS WITH MSD
Tara Dalton, Meghan Price, Edwin Owolo, Dana Rowe, James Herndon, Eli Johnson, Margaret Johnson, Elizabeth Fricklas, C Rory GoodwinAbstract
Introduction
Palliative Care (PC) can be instrumental in improving patient quality of life for patients with metastatic spine disease (MSD).We sought to evaluate the rates of PC utilization for patients with MSD across inpatient and outpatient settings as well as examine the impact of sociodemographic and treatment factors on the utilization of in-patient PC (IPPC) and outpatient PC (OPPC).
Methods
We examined IPPC and OPPC utilization in a cohort of 265 patients seen by our institution’s Brain and Spine Metastases Tumor Board (BSMTB) between February 1, 2018, and February 31, 2020. Statistical analyses were performed comparing characteristics and outcomes between patients who did or did not utilize IPPC and/or OPPC.
Results
We observed no difference in rates of IPPC and OPPC consultation between patients across gender or race. Outpatient PC consultations varied across insurance and primary tumor type (P = 0.056 and P = 0.025, respectively). Patients who received surgical intervention or radiation therapy within 30 days of being presented at tumor board had higher rates of OPPC utilization than those who did not (P = 0.0032 and P = 0.040, respectively). Patients who received an IPPC consult had worse overall survival than patients who did not consult IPPC (6.5 mo vs. 24.2 mo median survival) while those seen by OPPC had less of a survival disadvantage; median survival for OPPC was 11.2 months versus 19.2 months for those who were not seen by OPPC.
Conclusion
We identified differences in PC utilization across insurance and primary tumor type. Additionally, we present the unique finding that patients who receive surgery or RT for their spine metastases had higher rates of OPPC consultations than those who did not. Further work is needed to better appreciate PC utilization trends and identify interventions that improve the accessibility of PC.