A recent analysis of insurance claims data suggests that end-of-life (EOL) care for women with metastatic breast cancer has been associated with increases in rates of intensive care unit (ICU) visits and emergency department (ED) visits over time. Results of this analysis were published in the journal JCO Oncology Practice.1
In this study, the researchers evaluated claims data from a US insurer for the years 2000 through 2014 to determine patient and treatment characteristics with regard to EOL care for women with metastatic breast cancer. Outcomes of interest were the rates at which these patients had more than 1 hospitalization, more than 1 visit to an ED, a stay in an ICU, and/or antineoplastic treatment in their final 14 days of life.
The researchers identified 2126 women who died of metastatic breast cancer in this analysis, of whom 89% were older than 40 at diagnosis.
The researchers compared the study periods 2000 to 2003 and 2010 to 2014 and found an increase in EOL ICU admissions over time, with the rate being 14% (95% CI, 10%-17%) in the earlier period and 23% (95% CI, 20%-26%) in the later period (P <.01). EOL ED visits rose during these time periods from 10% (95% CI, 7%-13%) to 12% (95% CI, 9%-15%; P =.018). However, EOL hospitalizations and EOL antineoplastic treatment did not significantly vary across these periods of time.
“In this study, we find that, despite broadening consensus on less intense EOL care for patients with cancer, frequency of ICU admissions and, to a smaller extent, EOL ED visits in a cohort of commercially insured women who died with metastatic breast cancer has increased over time,” concluded the researchers in their report.
Ferrario A, Xu X, Zang F, Ross-Degnan D, Wharam JF, Wagner AK. Intensity of end-of-life care in a cohort of commercially insured women with metastatic breast cancer in the United States. JCO Oncol Pract. Published online November 10, 2020. doi:10.1200/OP.20.00089