According to a study published in JAMA Health Forum, many Medicare patients with advanced cancer receive potentially aggressive treatment at the expense of supportive care. The analysis, which examined records for 33,744 deceased Medicare beneficiaries aged 66 and older who died from breast, prostate, pancreatic or lung cancers over diverse ethnic backgrounds, found that 45% experienced potentially aggressive care such as multiple acute care visits in days leading up to death.
While hospice use spiked at more than 70% during the month of death, over 16% spent less than three days there. Receipt of advanced care planning and palliative care remained below 25%, indicating a significant focus on aggressive treatment instead of supportive care in end-of-life scenarios.
Access to hospice varied among different demographic groups. Older patients, non-Hispanic whites, those with longer survival durations, and residents living in rural areas or lower socioeconomic regions were less likely to receive this form of care. Youngmin Kwon, Ph.D., a research fellow at Vanderbilt University Medical Center’s Department of Health Policy, highlights the importance of hospice for managing dying patients’ holistic needs.
The findings underscore the need for multi-faceted efforts to optimize end-of-life care quality in cancer patients. Clear communication between patients, caregivers, and providers regarding disease prognosis and advanced planning is crucial. Additionally, policies increasing access to supportive care and ensuring an adequate workforce of palliative care providers are necessary to address structural barriers.
