Palliative care is crucial in alleviating the burden of advanced hepatocellular carcinoma (HCC) for patients and the healthcare system, but its utilization remains suboptimal. In an abstract presented at the 2024 ASCO Annual Meeting, researchers examined disparities in palliative care utilization among hospitalized patients with HCC.
Using data from the 2018-2020 National Inpatient Sample database, Rahman Adesoji Olusoji, MD, and colleagues conducted a retrospective cohort study of adult patients with HCC. The study focused on the variation in palliative care use based on race and other demographic factors. The researchers defined palliative care utilization as the patient receiving palliative care or being under the care of a palliative care physician or referral. The analysis included patient demographics, All Patient Refined Diagnosis Related Group (APR-DRG) risk of mortality, and their relationship with palliative care utilization.
Among 128,140 patients included in the study, 26,730 (20.9%) received palliative care. The researchers found that 50% of patients receiving palliative care had an extreme APR-DRG risk of mortality.
The study revealed significant racial disparities. The cohort predominantly consisted of White men, with White patients forming the largest group that received palliative care. Black patients had slightly increased odds of receiving palliative care (unadjusted OR, 1.08; 95% CI, 0.99-1.18; adjusted OR, 1.11; 95% CI, 1.01-1.22), while Hispanic patients had reduced odds (unadjusted OR, 0.83; 95% CI, 0.75-0.91; adjusted OR, 0.84; 95% CI, 0.76-0.93).
More than half the patients were treated in large, bed-sized hospitals and had Medicare. These findings suggest sociocultural factors and healthcare system dynamics could influence racial disparities in palliative care utilization, the researchers said. The overrepresentation of patients in large hospitals and those on Medicare underscores potential systemic influences on access to palliative care.
Dr. Olusoji and colleagues concluded that there were significant disparities in palliative care utilization among hospitalized patients with HCC, particularly affecting Black and Hispanic patients.
“Efforts are needed to address these disparities and ensure equitable care for all patients, particularly vulnerable populations. Further research and quality improvement initiatives are essential to explore and address these disparities and contributing factors, enhancing outcomes for patients with HCC,” the researchers concluded.
