Geographic Variations Found in Cancer Patient End-Of-Life Expenditures
Summary: These variations can be explained by service availability and physician beliefs in lower-spending vs higher-spending areas. Read on for more details and a link to Sg2 intelligence on community-based palliative care.
Using data from the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS), a recent Health Affairs study explored factors contributing to health care spending variations at the last 30 days of life for patients with advanced-stage lung or colorectal cancer, based on the patients’ sociodemographic and clinical factors, patients’ and physicians’ beliefs, and the availability of services.
Compared to physicians in lower-spending areas, physicians working in higher-spending areas reported having less knowledge about and feeling less comfortable with treating dying patients. Higher-spending areas were also found to have more physicians but fewer primary care providers and hospices compared to lower-spending areas. Findings from the study suggest that geographic variations within end-of-life spending can be explained by the availability of services as well as physicians’ beliefs.
While palliative care services can benefit patients with serious or life-threatening illnesses, many patients don’t have access to these services outside of the hospital. Sg2 believes that as payment reform evolves, community-based palliative care (CBPC)—a nonhospital, nonhospice palliative care model—will be an increasingly attractive opportunity to offer better care while reducing costs across the continuum. For more information on CBPCs, read the Sg2 FAQ Best Practices in Community-Based Palliative Care.