Documentation of information and care planning for patients with advanced cancer: associations with patient characteristics and utilization of hospital care.

OBJECTIVE

We evaluated the association between patient characteristics, utilization of care, and documentation of information and care planning.

METHODS

We abstracted chart documentation for 238 deceased patients with advanced cancer.

RESULTS

Do-not-resuscitate (DNR) orders were documented in 34% of charts, advance directives in 19%, hospice discussion in 49%, and hospice referral in 36%. Compared to white patients, black patients had a higher odds of hospice discussion (Adjusted Odds Ratio [AOR] 2.11; 95% CI 1.18 to 3.76) and hospice referral (AOR 2.18; 95% CI 1.21 to 3.93). Documentation of advance directive and DNR order was associated with higher utilization of care.

CONCLUSION

Black race was associated with higher odds of hospice discussion and referral in a primarily Medicaid population. Additional research is needed to explore variations in physician-patient discussion about hospice among different patient populations.