Latecomers to hospice frequently are male, have certain cancers, Penn researchers find

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Men and patients with certain types of cancer are among those less likely to enroll in hospice, suggesting that healthcare providers should focus on presenting these groups with all their end-of-life care options, according to newly published findings.

Being younger than 65, married, of nonwhite ethnicity and having blood or liver cancer were other risk factors for abrupt hospice admission in the last days of life, the investigators determined. They proposed several explanations, such as that married people have a spouse to aid with care. Blood cancer patients may need services such as transfusions that are not typically provided in hospice.

“It is essential to optimize transitions to hospice and make it easier for patients and their loved ones to access this care,” stated lead author Nina R. O'Connor, M.D., assistant professor of clinical medicine at the University of Pennsylvania Perelman School of Medicine. “Better integration of palliative care into cancer treatment – even that which is provided with curative intent – is one strategy that may be helpful.”

O'Connor and her colleagues examined electronic medical records of more than 64,000 patients in 12 hospices. More than 10,400 had a hospice stay of three days or fewer. Waiting until the final days of life to enter hospice could be depriving these patients of significant benefits, noted study co-author David Casarett, M.D., director of hospice and palliative care at Penn Medicine.

Full findings appear in the Journal of Clinical Oncology.