The Impact of Advanced Care Planning on Hospice Utilization in Patients with Cancer: A Nationwide Analysis in Korea.

Hospice and palliative care play key roles in facilitating goals-of-care discussions and managing symptoms in end-of-life (EOL) care for cancer patients. In this study, the association between completion of advance care planning (ACP), which refers to decisions regarding life-sustaining treatment, and hospice utilization in patients with cancer is examined. Data from the Korea-Clinical Data Utilization Network for Research Excellence were used. The study population included individuals diagnosed with one of the five leading causes of cancer-related deaths in South Korea. The association between the completion of ACP and hospice utilization was analyzed using multivariable logistic regression analysis. The study population included 50,574 patients with terminal cancer, of whom 10,530 (20.8%) had received hospice care. Self-determined ACP was completed by 9271 (18.3%) participants and non-self-determined ACP by 8654 (17.1%). Patients with ACP were more likely to receive hospice care, with the self-determined group (OR, 5.46; 95% CI: 5.13-5.81) showing a stronger association than the non-self-determined group (OR, 1.27; 95% CI: 1.18-1.37). Patients with cancer who completed ACP were more likely to use hospice care services. These findings indicate the potential importance of ACP decisions in providing EOL care.