Year: 2025
Type: article
Study design: Observational Study
Abstract: 108 Background: Aggressive care near death has been shown to increase healthcare costs and decrease quality of life for patients and caregivers without improving survival. We sought to compare end-of-life performance measures for women who died from a gynecologic malignancy and whose primary oncologist spoke their preferred language versus those who did not receive language-concordant care. Methods: Retrospective review of patients with a gynecologic malignancy who received care at our institution and died between March 1, 2020 and May 30, 2024. Language-concordant care was defined as care from a primary oncologist who fluently spoke the patient’s preferred language, as documented in the electronic medical record. We quantified the aggressiveness of end-of-life care using the National Quality Forum (NQF) performance measures, and outcomes were compared between those who received language-concordant versus language-discordant care. We used multivariable logistic regression to examine the association between language discordance and aggressive end-of-life care. Results: Of 83 patients included, 60 (72%) received language-concordant care and 23 (28%) received care from a doctor who did not speak their preferred language. After adjusting for age, insurance type, and cancer stage, patients who had language-discordant care were more likely to receive aggressive end-of-life care, defined as an NQF performance score of > / = 1 (aOR 6.05, 95% CI 1.38-16 . 15). The largest trends were seen in likelihood of receiving chemotherapy in the last 14 days of life (13% v. 3%, p = 0.12), admission to the Intensive Care Unit in the last 30 days of life (30% v. 22%, p = 0.38), and dying in the hospital (61% v. 40%, p = 0.08). The two groups performed similarly on the number of Emergency Room visits and overall hospitalizations in the last 30 days, as well as rates of referral to Palliative Care at least 4 days before death. Conclusions: Between 2020 and 2024, women who died from a gynecologic malignancy and received care at our institution were more likely to receive aggressive end-of-life care if they did not speak the same language as their primary oncologist. Overall Language Concordant Not Language Concordant n % n % n % p value NQF Score 0.0174 0 27 32.53 24 40 3 13.04 ≥1 56 67.47 36 60 20 86.96 Chemotherapy 0.1236 No 78 93.98 58 96.67 20 86.96 Yes 5 6.02 2 3.33 3 13.04 Emergency Department 0.7002 No 67 80.72 48 80 19 82.61 Yes 16 19.28 12 20 4 17.39 Hospitalization 0.7537 No 66 79.52 47
Source: Journal of Palliative Medicine
Authors: Katherine Yoh, Lielle R. Yellin, Joel Agarwal, Patricia Finnegan, Reena M. Vattakalam, Alexandre Buckley De Meritens, Shayan Dioun, Thomas C. Randall, Tarah Pua, Caryn M. St Clair, Jason D. Wright, June Y. Hou
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4414893147