Changes in the place of death for older adults with cancer: Reason to celebrate or a risk for unintended disparities?
End of life
Geriatric oncology
Hospice care
Palliative care
Place of death
Journal
Journal of geriatric oncology
ISSN: 1879-4076
Titre abrégé: J Geriatr Oncol
Pays: Netherlands
ID NLM: 101534770
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
received:
06
05
2020
revised:
28
08
2020
accepted:
15
10
2020
pubmed:
31
10
2020
medline:
29
7
2021
entrez:
30
10
2020
Statut:
ppublish
Résumé
Place of death is important to patients and caregivers, and often a surrogate measure of health care disparities. While recent trends in place of death suggest an increased frequency of dying at home, data is largely unknown for older adults with cancer. Deidentified death certificate data were obtained via the National Center for Health Statistics. All lung, colon, prostate, breast, and pancreas cancer deaths for older adults (defined as >65 years of age) from 2003 to 2017 were included. Multinomial logistic regression was used to test for differences in place of death associated with sociodemographic variables. From 2003 through 2017, a total of 3,182,707 older adults died from lung, colon, breast, prostate and pancreas cancer. During this time, hospital and nursing home deaths decreased, and the rate of home and hospice facility deaths increased (all p < 0.001). In multivariable regression, all assessed variables were found to be associated with place of death. Overall, older age was associated with increased risk of nursing facility death versus home death. Black patients were more likely to experience hospital death (OR 1.7) and Hispanic ethnicity had lower odds of death in a nursing facility (OR 0.55). Since 2003, deaths in hospice facilities rapidly increased by 15%. Hospital and nursing facility cancer deaths among older adults with cancer decreased since 2003, while deaths at home and hospice facilities increased. Differences in place of death were noted for non-white patients and older adults of advanced age.
Sections du résumé
BACKGROUND
Place of death is important to patients and caregivers, and often a surrogate measure of health care disparities. While recent trends in place of death suggest an increased frequency of dying at home, data is largely unknown for older adults with cancer.
METHODS
Deidentified death certificate data were obtained via the National Center for Health Statistics. All lung, colon, prostate, breast, and pancreas cancer deaths for older adults (defined as >65 years of age) from 2003 to 2017 were included. Multinomial logistic regression was used to test for differences in place of death associated with sociodemographic variables.
RESULTS
From 2003 through 2017, a total of 3,182,707 older adults died from lung, colon, breast, prostate and pancreas cancer. During this time, hospital and nursing home deaths decreased, and the rate of home and hospice facility deaths increased (all p < 0.001). In multivariable regression, all assessed variables were found to be associated with place of death. Overall, older age was associated with increased risk of nursing facility death versus home death. Black patients were more likely to experience hospital death (OR 1.7) and Hispanic ethnicity had lower odds of death in a nursing facility (OR 0.55). Since 2003, deaths in hospice facilities rapidly increased by 15%.
CONCLUSION
Hospital and nursing facility cancer deaths among older adults with cancer decreased since 2003, while deaths at home and hospice facilities increased. Differences in place of death were noted for non-white patients and older adults of advanced age.
Identifiants
pubmed: 33121909
pii: S1879-4068(20)30480-X
doi: 10.1016/j.jgo.2020.10.008
pmc: PMC8428799
mid: NIHMS1640234
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
361-367Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : NIA NIH HHS
ID : T32 AG000247
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors have no competing interests.
Références
J Palliat Med. 2019 Apr;22(4):408-412
pubmed: 30589624
Ann Oncol. 2010 Feb;21(2):362-369
pubmed: 19654197
J Natl Med Assoc. 2008 Dec;100(12):1457-62
pubmed: 19110915
Med Care Res Rev. 2007 Aug;64(4):351-78
pubmed: 17684107
Eur J Cancer. 2019 Jul;116:116-136
pubmed: 31195356
J Gastrointest Surg. 2017 Dec;21(12):2033-2038
pubmed: 28785936
J Gen Intern Med. 1996 Jul;11(7):387-96
pubmed: 8842929
JAMA. 2013 Feb 6;309(5):470-7
pubmed: 23385273
Public Health Rep. 1983 Mar-Apr;98(2):170-6
pubmed: 6856741
JAMA. 2018 Jul 17;320(3):264-271
pubmed: 29946682
J Gen Intern Med. 1999 Jan;14(1):15-20
pubmed: 9893086
BMC Palliat Care. 2016 Sep 23;15(1):83
pubmed: 27662830
Manag Care. 2015 Oct;24(10):46-7, 52-4
pubmed: 26665715
J Am Geriatr Soc. 2008 Oct;56(10):1904-9
pubmed: 18775035
Evid Rep Technol Assess (Full Rep). 2012 Oct;(208.8):1-249
pubmed: 24423021
J Natl Cancer Inst. 2015 Oct 05;108(1):
pubmed: 26438575
JAMA Oncol. 2016 Jul 1;2(7):957-8
pubmed: 27123556
J Palliat Med. 2019 Sep;22(S1):90-100
pubmed: 31486728
J Clin Oncol. 2014 Aug 20;32(24):2595-603
pubmed: 25071125
Ann Intern Med. 2003 Feb 18;138(4):288-98
pubmed: 12585826
BMC Palliat Care. 2013 Feb 15;12:7
pubmed: 23414145
JAMA. 2016 Nov 22;316(20):2104-2114
pubmed: 27893131
N Engl J Med. 1999 Sep 23;341(13):956-63
pubmed: 10498492
JAMA. 2000 Nov 15;284(19):2489-94
pubmed: 11074779
J Natl Cancer Inst. 2011 Jan 19;103(2):117-28
pubmed: 21228314
Cancers (Basel). 2017 Jan 24;9(2):
pubmed: 28125017
J Am Geriatr Soc. 2016 Sep;64(9):1815-22
pubmed: 27534517
J Epidemiol Community Health. 2016 Jan;70(1):17-24
pubmed: 26202254
Gerontologist. 2005 Oct;45(5):642-50
pubmed: 16199399
J Clin Oncol. 2017 Jan;35(1):96-112
pubmed: 28034065
Health Soc Work. 2008 Nov;33(4):267-74
pubmed: 19070274
J Pain Symptom Manage. 2019 Jan;57(1):64-72
pubmed: 30267845
CMAJ. 2003 Feb 4;168(3):265-70
pubmed: 12566330
Chest. 2020 Aug;158(2):670-680
pubmed: 32229227
J Clin Oncol. 2004 Jan 15;22(2):315-21
pubmed: 14722041
Br J Cancer. 2015 Nov 3;113(9):1397-404
pubmed: 26325102
Br J Cancer. 2006 Sep 4;95(5):593-600
pubmed: 16909139
J Pain Symptom Manage. 2017 Aug;54(2):167-175
pubmed: 28479411
J Am Geriatr Soc. 2008 Oct;56(10):1953-8
pubmed: 18771455
JAMA. 2003 May 7;289(17):2238-45
pubmed: 12734135
Ann Oncol. 2012 Aug;23(8):2006-2015
pubmed: 22345118
NPJ Prim Care Respir Med. 2017 Dec;27(1):14
pubmed: 28258277
JAMA. 2004 Jan 7;291(1):88-93
pubmed: 14709580
J Clin Oncol. 2015 Nov 10;33(32):3802-8
pubmed: 26324373
BMJ. 2006 Mar 4;332(7540):515-21
pubmed: 16467346
JAMA Intern Med. 2013 Mar 25;173(6):450-6
pubmed: 23420383
J Am Med Dir Assoc. 2015 Feb;16(2):90-2
pubmed: 25512213
N Engl J Med. 1989 Oct 26;321(17):1168-73
pubmed: 2677726
Blood Adv. 2019 Feb 12;3(3):333-338
pubmed: 30709864
BMJ. 2004 Mar 13;328(7440):607
pubmed: 15016692
J Oncol Pract. 2014 Jul;10(4):281-7
pubmed: 24917264
N Engl J Med. 2019 Dec 12;381(24):2369-2370
pubmed: 31826345
Palliat Med. 2018 Jan;32(1):69-78
pubmed: 29130418
J Palliat Med. 2016 Mar;19(3):263-70
pubmed: 26673031
J Pain Symptom Manage. 2016 Feb;51(2):204-12
pubmed: 26514717
J Am Geriatr Soc. 2005 Nov;53(11):1905-11
pubmed: 16274371
J Hosp Med. 2016 Oct;11(10):688-693
pubmed: 27222206
J Am Geriatr Soc. 2002 May;50(5):829-35
pubmed: 12028168
J Clin Oncol. 2015 Nov 10;33(32):3826-33
pubmed: 26195697
J Clin Oncol. 2012 Mar 10;30(8):880-7
pubmed: 22312101
Soc Sci Med. 2003 Aug;57(3):465-75
pubmed: 12791489
Health Aff (Millwood). 2004 May-Jun;23(3):194-200
pubmed: 15160817
J Hosp Med. 2013 Nov;8(11):601-8
pubmed: 24038927
Cancer. 2018 Nov 15;124(22):4408-4419
pubmed: 30343501