|The following article features coverage from the American Society of Hematology 2019 Annual Meeting. Click here to read more of Oncology Nurse Advisor‘s conference coverage.|
Medicare patients with hematologic malignancies have increasingly made use of billed palliative care services (BPCS), according to a study presented at the 61st American Society of Hematology (ASH) Annual Meeting & Exposition, held in Orlando, Florida. However, this use has primarily been in the context of end-of-life (EOL) care, rather than occurring earlier in treatment.
The study investigators evaluated records from the Surveillance, Epidemiology, and End Results – Medicare database for patients with common hematologic malignancies and who had died (N=139,191). Included patients had received fee-for-service Medicare. The study investigators analyzed use of the BPCS in relation to the time of a patient’s death, with early BPCS use defined as occurring more than 30 days before a patient’s death.
Overall, 5.2% of patients had made use of BPCS at any point, with 84.3% of encounters occurring in hospital settings. BPCS utilization in 2001 occurred at a rate of 0.4%. In 2015, this rate had risen to 13.3%. BPCS claims for nurse practitioners rose substantially throughout the study period.
In 2001, the median usage of BPCS occurred 6 days before death, and in 2015, the median usage had shifted to 12 days before death. Early BPCS use occurred in a low proportion of patients throughout the study period. However, the 2001 rate of early BPCS use was 0.2%, compared with 4.3% in 2015.
For patients who had survived more than 30 days post-diagnosis (n=120,741), early BPCS was associated with improved EOL care. Early BPCS use was also linked to lower average Medicare costs in the final 30 days of patients’ lives (P <.001).
According to the researchers, further research should assess barriers to utilization of BPCS, and prospective research should be conducted on BPCS in patients with hematologic malignancies.
Disclosure: Multiple authors declared affiliations with industry. Please refer to the original abstract for a full list of disclosures.
Rao VB, Belanger E, Egan PC, LeBlanc TW, Olszewski AJ. Billed palliative care services and end-of-life care in patients with hematologic malignancies. Oral presentation at: 61st ASH Annual Meeting & Exposition; December 7-10, 2019; Orlando, FL. Abstract 384.