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Characteristics Associated with In-Hospital Death among Commercially Insured Decedents with Cancer

Published on Jan 1, 2017in Journal of Palliative Medicine 2.48
· DOI :10.1089/jpm.2016.0231
Gabriel A. Brooks8
Estimated H-index: 8
,
Sherri O. Stuver33
Estimated H-index: 33
+ 5 AuthorsJoseph O. Jacobson25
Estimated H-index: 25
Cite
Abstract
Abstract Background: A majority of patients with poor-prognosis cancer express a preference for in-home death; however, in-hospital deaths are common. Objective: We sought to identify characteristics associated with in-hospital death. Design: Case series. Setting/Subjects: Commercially insured patients with cancer who died between July 2010 and December 2013 and who had at least two outpatient visits at a tertiary cancer center during the last six months of life. Measurements: Patient characteristics, healthcare utilization, and in-hospital death (primary outcome) were ascertained from institutional records and healthcare claims. Bivariate and multivariable analyses were used to evaluate the association of in-hospital death with patient characteristics and end-of-life outcome measures. Results: We identified 904 decedents, with a median age of 59 years at death. In-hospital death was observed in 254 patients (28%), including 110 (12%) who died in an intensive care unit. Hematologic malignancy was associat...
  • References (23)
  • Citations (1)
Cite
References23
Newest
Published on Aug 1, 2016in Journal of Pain and Symptom Management 3.38
Sherri O. Stuver33
Estimated H-index: 33
(BU: Boston University),
Kristen K. McNiff15
Estimated H-index: 15
(Harvard University)
+ 4 AuthorsJoseph O. Jacobson25
Estimated H-index: 25
(Harvard University)
Abstract Context Understanding end-of-life (EOL) care patterns is a prerequisite to improving the experience for cancer patients. EOL measures endorsed by the National Quality Forum (NQF) have been examined in older patients using Medicare claims. Objectives To evaluate EOL care for patients treated at a comprehensive cancer center, using private payer claims data. Methods A retrospective cohort study was conducted of Dana-Farber Cancer Institute (DFCI) patients who died between July 2010 and De...
Published on Jul 1, 2016in Medical Care 3.79
Melissa D. Aldridge9
Estimated H-index: 9
(ISMMS: Icahn School of Medicine at Mount Sinai),
Andrew J. Epstein30
Estimated H-index: 30
(UPenn: University of Pennsylvania)
+ 3 AuthorsElizabeth H. Bradley70
Estimated H-index: 70
(Yale University)
Background: The Affordable Care Act requires hospices to report quality measures across a range of processes and practices. Yet uncertainties exist regarding the impact of hospice preferred practices on patient outcomes. Objective: Assess the impact of 6 hospice preferred practices and hospice organizational characteristics on hospital utilization and death using the first national data on hospice preferred practices. Design: Longitudinal cohort study (2008–2011) of Medicare beneficiaries (N=149...
Published on Mar 1, 2016in Journal of Geriatric Oncology 3.16
Shi-Yi Wang16
Estimated H-index: 16
(Yale University),
Jane Hall5
Estimated H-index: 5
(Yale University)
+ 4 AuthorsCary P. Gross52
Estimated H-index: 52
(Yale University)
Abstract Objectives To examine contemporary trends in end-of-life cancer care and geographic variation of end-of-life care aggressiveness among Medicare beneficiaries. Materials and Methods Using the Surveillance, Epidemiology, and End Results—Medicare data, we identified 132,051 beneficiaries who died as a result of cancer in 2006–2011. Aggressiveness of end-of-life care was measured by chemotherapy received within 14days of death, >1 emergency department (ED) visit within 30days of death, >1 h...
Published on Jan 19, 2016in JAMA 51.27
Alexi A. Wright34
Estimated H-index: 34
(Harvard University),
Nancy L. Keating55
Estimated H-index: 55
(Harvard University)
+ 6 AuthorsMary Beth Landrum41
Estimated H-index: 41
(Harvard University)
Importance Patients with advanced-stage cancer are receiving increasingly aggressive medical care near death, despite growing concerns that this reflects poor-quality care. Objective To assess the association of aggressive end-of-life care with bereaved family members’ perceptions of the quality of end-of-life care and patients’ goal attainment. Design, Setting, and Participants Interviews with 1146 family members of Medicare patients with advanced-stage lung or colorectal cancer in the Cancer C...
Published on Jan 19, 2016in JAMA 51.27
Justin E. Bekelman25
Estimated H-index: 25
(UPenn: University of Pennsylvania),
Scott D. Halpern39
Estimated H-index: 39
(UPenn: University of Pennsylvania)
+ 14 AuthorsBregje D. Onwuteaka-Philipsen48
Estimated H-index: 48
(VUmc: VU University Medical Center)
Importance Differences in utilization and costs of end-of-life care among developed countries are of considerable policy interest. Objective To compare site of death, health care utilization, and hospital expenditures in 7 countries: Belgium, Canada, England, Germany, the Netherlands, Norway, and the United States. Design, Setting, and Participants Retrospective cohort study using administrative and registry data from 2010. Participants were decedents older than 65 years who died with cancer. Se...
Published on Jan 19, 2016in JAMA 51.27
Oreofe O. Odejide12
Estimated H-index: 12
(Harvard University)
Published on May 1, 2015in Journal of Oncology Practice
Lisa Barbera25
Estimated H-index: 25
,
Hsien Seow17
Estimated H-index: 17
+ 8 AuthorsReka Pataky4
Estimated H-index: 4
There is significant variation in end-of-life quality indicators across regions in four provinces in Canada. Applying this study's methods can support quality improvement by decreasing variation and striving for a target.
Published on Nov 12, 2014in JAMA 51.27
Ziad Obermeyer16
Estimated H-index: 16
(Harvard University),
Maggie Makar6
Estimated H-index: 6
(Brigham and Women's Hospital)
+ 3 AuthorsDavid M. Cutler75
Estimated H-index: 75
(Harvard University)
Importance More patients with cancer use hospice currently than ever before, but there are indications that care intensity outside of hospice is increasing, and length of hospice stay decreasing. Uncertainties regarding how hospice affects health care utilization and costs have hampered efforts to promote it. Objective To compare utilization and costs of health care for patients with poor-prognosis cancers enrolled in hospice vs similar patients without hospice care. Design, Setting, and Partici...
Published on Nov 1, 2014in Neuro-oncology 10.09
Nils D. Arvold21
Estimated H-index: 21
(Partners HealthCare),
Yongfei Wang95
Estimated H-index: 95
+ 2 AuthorsFrancesca Dominici61
Estimated H-index: 61
Glioblastoma multiforme (GBM) is the most common malignant primary brain tumor and is associated with a dismal prognosis, especially among the elderly. The median age at diagnosis is ∼65 years,1 and while patients may be told that the median survival for GBM is ∼15 months, this figure comes from a randomized trial of selected patients with good performance status and a median age of 56 years, and excluded patients over age 70.2 In contrast, population-based data from the Surveillance, Epidemiolo...
Published on Oct 1, 2014in Health Affairs 5.71
Gabriel A. Brooks8
Estimated H-index: 8
(Harvard University),
Ling Li6
Estimated H-index: 6
(Harvard University)
+ 3 AuthorsDeborah Schrag83
Estimated H-index: 83
(Harvard University)
The root causes of regional variation in medical spending are poorly understood and vary by clinical condition. To identify drivers of regional spending variation for Medicare patients with advanced cancer, we used linked Surveillance, Epidemiology, and End Results program (SEER)–Medicare data from the period 2004–10. We broke down Medicare spending into thirteen cancer-relevant service categories. We then calculated the contribution of each category to spending and regional spending variation. ...
Cited By1
Newest
Published on Nov 1, 2017in Journal of Oncology Practice
Cara L. McDermott7
Estimated H-index: 7
,
Catherine R. Fedorenko12
Estimated H-index: 12
+ 5 AuthorsScott D. Ramsey8
Estimated H-index: 8
Purpose:Despite guidelines emphasizing symptom management over aggressive treatment, end-of-life care for persons with cancer in the United States is highly variable. In consultation with a regional collaboration of patients, providers, and payers, we investigated indicators of high-quality end-of-life care to describe patterns of care, identify areas for improvement, and inform future interventions to enhance end-of-life care for patients with cancer.Methods:We linked insurance claims to clinic...