Olafimihan Ayobami, Jackson Inimfon, Nwachukwu Chiamaka, Ozogbo Stanley, Oh Youjin, George Lina, Fawehinmi Praise, Abdullahi Abubakar, Mullane Michael
Department of Internal Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, IL, USA.
Department of Hematology Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Am J Hosp Palliat Care. 2025 Apr;42(4):404-412. doi: 10.1177/10499091241256627. Epub 2024 May 23.
Several factors are reported to be associated with palliative care utilization among patients with various cancers, but literature is lacking on metastatic prostate cancer (MPC) specific factors. Early integration of palliative care in management of MPC patients could increase their quality of life and overall outcomes. Retrospective longitudinal analyses were conducted using the National Inpatient Sample (NIS) data (2010 - 2019). Prevalence trends in palliative care utilization were assessed, and sociodemographic and hospital-level factors associated with palliative care utilization in MPC patients were examined. The overall prevalence of palliative care utilization was 13.1% with an increasing trend from 8490 to 15,231 per 100,000 MPC admissions (p-trend <.001). MPC patients aged 65 years and above had similar odds of receiving palliative care compared to younger patients. Relative to non-Hispanic Whites, other racial groups had similar likelihood to utilize palliative care services. Patients in higher median household national income quartiles had greater odds of utilizing palliative care relative to those in the first income quartile. Patients on Medicaid, private insurance and other insurance types had greater odds of palliative care use in comparison to those on Medicare. Other factors identified were hospital region, location and teaching status, patient disposition, admission type, length of stay, and number of comorbidities. Our findings underscore the significance of enhanced government policies and institutional support in improving palliative care use among hospitalized MPC patients. Health systems must be proactive in addressing barriers to optimization of palliative care utilization in this population.
据报道，多种因素与各类癌症患者的姑息治疗利用情况相关，但关于转移性前列腺癌（MPC）的特定因素的文献却很缺乏。在MPC患者的管理中早期整合姑息治疗可以提高他们的生活质量和总体预后。使用国家住院样本（NIS）数据（2010 - 2019年）进行了回顾性纵向分析。评估了姑息治疗利用的患病率趋势，并研究了与MPC患者姑息治疗利用相关的社会人口统计学和医院层面的因素。姑息治疗利用的总体患病率为13.1%，每10万例MPC入院患者中从8490例增加到15231例，呈上升趋势（p趋势<.001）。65岁及以上的MPC患者接受姑息治疗的几率与年轻患者相似。相对于非西班牙裔白人，其他种族群体使用姑息治疗服务的可能性相似。家庭收入中位数处于较高四分位数的患者相对于处于第一收入四分位数的患者使用姑息治疗的几率更大。与医疗保险患者相比，医疗补助、私人保险和其他保险类型的患者使用姑息治疗的几率更大。确定的其他因素包括医院地区、位置和教学状况、患者处置情况、入院类型、住院时间和合并症数量。我们的研究结果强调了加强政府政策和机构支持在提高住院MPC患者姑息治疗使用率方面的重要性。卫生系统必须积极应对该人群中优化姑息治疗利用的障碍。
