Racial and hospital factors affecting palliative care utilization in advanced cancer: An analysis of the NIS database

Document Type

Conference Proceeding

Publication Date

9-18-2025

Publication Title

Cancer Epidemiol Biomarkers Prev

Keywords

Oncology, Public, Environmental & Occupational Health

Abstract

Background: Palliative care significantly enhances the quality of life for patients with advanced cancer by addressing symptom management and end-of-life needs. Despite its benefits, palliative care utilization remains inconsistent. This study investigates factors associated with palliative care access among advanced cancer patients using data from the 2020 National Inpatient Sample (NIS). Methods: We analyzed data from the 2020 NIS to evaluate palliative care utilization among patients with metastatic cancer (ICD-10 codes C78, C79, C77) and cancers of unknown primary origin (C80). Descriptive statistics, chi-square tests, and logistic regression models were used to examine associations between palliative care access and demographic, clinical, and hospital characteristics. Analyses were conducted using R version 4.5.0. Results: This study analyzed 4,098 advanced cancer patients from the 2020 NIS to investigate palliative care utilization. Of these, 1,044 patients (25.5%) received palliative care. Patients receiving palliative care had a longer mean length of hospital stay (8.91 days vs. 7.97 days, β = 0.92, p = 0.0027), but the difference in total hospital charges was not significantly different ($119,029 vs. $116,440, p = 0.685). Logistic regression showed hospital teaching status as a significant predictor of improved palliative care access/utilization (OR = 1.75, p = 0.0418). Regarding race, 65.4% of White patients received palliative care, compared to 26.3% of Black, 27.8% of Hispanic, and 31.6% of other racial groups. Race was overall not a significant predictor of palliative care utilization (p = 0.353). Sex was also not associated with any significant difference in utilization of palliative care (p = 0.382). Hospital teaching status was the only key factor associated with the likelihood of receiving palliative care. Conclusion: This study highlights disparities in palliative care use among advanced cancer patients, with hospital teaching status emerging as a key factor. Race and gender were not significant predictors. Addressing institutional factors may help improve access across hospital types.

Volume

34

Issue

9

First Page

C1

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