ArticleJournal of geriatric oncology2017
Social determinants, multimorbidity, and patterns of end-of-life care in older adults dying from cancer.
Article in Journal of geriatric oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Age- and gender-based social inequalities in palliative care for cancer patients: a systematic literature review.Frontiers in public health · 2024Pooled it
- Transfusion dependence, use of hospice services, and quality of end-of-life care in leukemia.Blood · 2018Trial
- Relationship Between the Preferred Place of Death in Patients' Health Records and the Actual Location of Death in Home Palliative Care: A Retrospective Cohort Study.Healthcare (Basel, Switzerland) · 2026Article
- Heterogeneity of Effect of Specialist Palliative Care for Black and Non-Hispanic White Older Adults With Metastatic Cancer.Journal of the American Geriatrics Society · 2025Article
- Housing instability and psychological distress in African American cancer survivors: findings from the Detroit Research on Cancer Survivors study.Journal of cancer survivorship : research and practice · 2025Observational
- "Who You Are and Where You Live Matters": Hospice Care in New York City During COVID-19 Perspectives on Hospice and Social Determinants: A Rapid Qualitative Analysis.Journal of palliative medicine · 2025Article
- A scoping review of racial, ethnic, socioeconomic, and geographic disparities in the outcomes of older adults with cancer.Journal of the American Geriatrics Society · 2024Article
- Social Deprivation and End-of-Life Care Use Among Adults With Cancer.JCO oncology practice · 2024Article
- Factors Affecting Hospice Use Among Adolescents and Young Adult Cancer Patients.Journal of adolescent and young adult oncology · 2023Article
- Incidence of Aggressive End-of-Life Care Among Older Adults With Metastatic Cancer Living in Nursing Homes and Community Settings.JAMA network open · 2023Article
- Need of community-based palliative care in rural India and factors that influence its sustainability: a comprehensive exploration using qualitative methodology in rural Puducherry, India.Palliative care and social practice · 2023Article
- The end of life experiences of people living with socio-economic deprivation in the developed world: an integrative review.BMC palliative care · 2022Review
- A prospective cohort study assessing aggressive interventions at the end-of-life among patients with solid metastatic cancer.BMC palliative care · 2022Article
- Article
- The Association of Advance Care Planning Documentation and End-of-Life Healthcare Use Among Patients With Multimorbidity.The American journal of hospice & palliative care · 2021Article
- Understanding Treatment Tolerability in Older Adults With Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021Review
- Racial Disparities in End-of-Life Care Between Black and White Adults With Metastatic Cancer.Journal of pain and symptom management · 2021Article
- Health Related Social Needs Among Chinese American Primary Care Patients During the COVID-19 Pandemic: Implications for Cancer Screening and Primary Care.Frontiers in public health · 2021Article
- Health care utilization at end of life among patients with lung or pancreatic cancer. Comparison between two Swedish cohorts.PloS one · 2021Article
- The Association between Chronic Conditions, End-of-Life Health Care Use, and Documentation of Advance Care Planning among Patients with Cancer.Journal of palliative medicine · 2020Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveMost prior studies on aggressive end-of-life care in older patients with cancer have accounted for social determinants of health (e.g., race, income, and education), but rarely for multimoribidity (MM). In this study, we examine the association between end-of-life care and each of the social determinants of health and MM, hypothesizing that higher MM is associated with less aggressive care.
methodsFrom the linked 1991-2008 Health and Retirement Study, Medicare data, and the National Death Index, we identified fee-for-service patients age ≥66years who died from cancer (n=835). MM was defined as the occurrence or co-occurrence of chronic conditions, functional limitations, and/or geriatric syndromes. Aggressive care was based on claims-derived measures of receipt of cancer-directed treatment in the last two weeks of life; admission to the hospital and/or emergency department (ED) within the last month; and in-hospital death. We also identified patients enrolled in hospice. In multivariable logistic regression models, we analyzed the associations of interest, adjusting for potential confounders.
resultsWhile 61.2% of the patients enrolled in hospice, 24.6% underwent cancer-directed treatment; 55.1% were admitted to the hospital and/or ED; and 21.7% died in the hospital. We observed a U-shaped distribution between income and in-hospital death. Chronic conditions and geriatric syndromes were associated with some outcomes, but not with others.
conclusionsTo improve quality end-of-life care and curtail costs incurred by dying patients, relevant interventions need to account for social determinants of health and MM in a nuanced fashion.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.