Pd15-08 Site of Care and Its Impact on Receipt of Palliative Care for Black Men With Metastatic Prostate Cancer?
Year: 2019
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) I (PD15)1 Apr 2019PD15-08 SITE OF CARE AND ITS IMPACT ON RECEIPT OF PALLIATIVE CARE FOR BLACK MEN WITH METASTATIC PROSTATE CANCER? Alexander Putnam Cole*, Akezhan Meirkhanov, Sean Anthony Fletcher, Zara Cooper, Stuart R. Lipsitz, Joel S. Weissmann, Kerry L. Kilbridge, Adam S. Kibel, and Quoc-Dien Trinh Alexander Putnam Cole*Alexander Putnam Cole* More articles by this author , Akezhan MeirkhanovAkezhan Meirkhanov More articles by this author , Sean Anthony FletcherSean Anthony Fletcher More articles by this author , Zara CooperZara Cooper More articles by this author , Stuart R. LipsitzStuart R. Lipsitz More articles by this author , Joel S. WeissmannJoel S. Weissmann More articles by this author , Kerry L. KilbridgeKerry L. Kilbridge More articles by this author , Adam S. KibelAdam S. Kibel More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555459.30099.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: There is evidence that members of racial and ethnic minority groups may be less likely to receive palliative care compared to non-Hispanic Whites. This may be due to either to different treatment of minority patients by physicians, or from less utilization of palliative care at the relatively small number of hospitals which treat a large portion of minority patients. To assess the impact of site of care on disparities in palliative care, we assessed whether receipt of palliative care among men with metastatic prostate cancer differed at hospitals which predominantly treat minority patients. METHODS: We abstracted data on men >40 years of age, with metastatic prostate cancer within the National Cancer Database. The receipt of palliative care was compared in each racial group. Hospitals in the top decile in terms of the proportion of Black and Hispanic patients were defined as minority-serving hospitals (MSHs). A multilevel logistic regression model estimating the odds of receiving palliative care based on MSH status was fit, adjusting for year of diagnosis, sex, race, insurance, income, and education, with a hospital-level random intercept to account for unmeasured hospital characteristics. RESULTS: Our study cohort consisted of 44,521 men with metastatic prostate cancer. The average age was 71.3 (95% CI 71.1-71.6). Of these men, 7096 (15.9%) were treated at MSHs. The proportion of men of receiving palliative care differed based on race: Overall 15.9% of white men received palliative care for prostate cancer, whereas only 14.7% of black men and 12.0% of Hispanics received palliative care (p <0.001). In our model adjusting for clinical and demographic variables, and minority serving hospital status, MSH status had a large and statistically significant association with lower odds of palliative care (OR 0.67 95% CI 0.55-0.82), whereas Black and Hispanic race did not (OR 1.00 95% 0.91-1.09) and (0.98 95% 0.85-1.13). CONCLUSIONS: In our adjusted model, treatment at an MSH had a large and statistically significant impact on receipt of palliative care; patient race did not. These findings suggest that the site of care, may account for much of the observed race-based disparities in palliative care in prostate cancer. Targeting MSHs may represent an effective strategy to combat disparities in palliative care. Source of Funding: Brigham Research Institute, Bruce A. Beal and Robert L. Beal Surgical Fellowship, Conquer Cancer Foundation, Defense Health Agency, Intuitive Surgical, Prostate Cancer Foundation, Vattikuti Urology Institute. Boston, MA© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e240-e240 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexander Putnam Cole* More articles by this author Akezhan Meirkhanov More articles by this author Sean Anthony Fletcher More articles by this author Zara Cooper More articles by this author Stuart R. Lipsitz More articles by this author Joel S. Weissmann More articles by this author Kerry L. Kilbridge More articles by this author Adam S. Kibel More articles by this author Quoc-Dien Trinh More articles by this author Expand All Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2941298977