• Yun-Ju Lai, Yu-Yen Chen, Ming-Chung Ko, Yi-Sheng Chou, Li-Ying Huang, Yi-Tui Chen, Kuo-Chuan Hung, Yu-Kai Lin, Chun-Chieh Wang, Chu-Chieh Chen, Pei-Hung Chuang, and Yung-Feng Yen.
• School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan; Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan.
• J Pain Symptom Manage. 2020 Aug 1; 60 (2): 309-315.e1.

ContextSocioeconomic status (SES) is an important determinant of disparities in health services and may affect the utilization of hospice care services during end-of-life (EOL) treatment in patients with cancer. However, previous studies evaluating the association between SES and utilization of hospice care services among patients with cancer revealed inconsistent findings.ObjectivesThis study aimed to determine the association between SES and utilization of hospice care services during the last year of life in patients with cancer.MethodsFrom January 1, 2006 to December 31, 2016, we identified adults with cancer diagnoses from the Registry for Catastrophic Illness in Taiwan. The cancer diagnoses in study subjects were proved by the pathohistological reports. The utilization of hospice care services during the last year of life in patients with cancer included hospice inpatient care, hospice-shared care, and hospice home care.ResultsIn the follow-up period, 28.6% of 516,409 patients with cancer used hospice care services during the last year of life. After adjusting for other covariates, low SES significantly reduced the utilization of hospice care services by 18% during the last year of life in patients with cancer. Moreover, a positive trend between decreasing levels of SES and lower utilization of hospice care during EOL treatment was noted (P < 0.001).ConclusionLow SES was associated with lower utilization of hospice care services during EOL care in patients with cancer. Our data support the need to target low SES patients with cancer in efforts to optimally increase hospice care services during EOL care.Copyright © 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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