Evidence map›Paper›PMID 32069191›Full record

ArticleJCO oncology practice2020

Association Between Delivery System Structure and Intensity of End-of-Life Cancer Care.

Lindsey A Herrel, Ziwei Zhu, Jennifer J Griggs, Deborah R Kaye, James M Dupree, Chandy S Ellimoottil, David C Miller

Abstract read
In one paragraph

Article in JCO oncology practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Lindsey A HerrelThe University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI.
Ziwei ZhuThe University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI.
Jennifer J GriggsThe University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI.
Deborah R KayeThe University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI.
James M DupreeThe University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI.
Chandy S EllimoottilThe University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI.
David C MillerThe University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, MI.

Funding

Understanding optimal delivery systems for cancer careR01CA174768 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MILLER, DAVID C · 2014 to 2018
$2.0M
Understanding the effects of the Oncology Care Model on cancer care for dual eligible patientsK08CA237638 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HERREL, LINDSEY ALLISON · 2019 to 2023
$1.1M
Physician Organization and the Efficiency of Surgical Specialty CareK08HS018346 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MILLER, DAVID C · 2010 to 2013
$620k
Variation in surgical care for early-stage kidney cancerF32CA123819 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI MILLER, DAVID C · 2006 to 2006
$58k
AHRQ HHS K08 HS018346NCI NIH HHS F32 CA123819NCI NIH HHS R01 CA174768
6 · The paper itself

Abstract

purposeTo determine whether the type of delivery system is associated with intensity of care at the end of life for Medicare beneficiaries with cancer. PATIENTS AND

methodsWe used SEER registry data linked with Medicare claims to evaluate intensity of end-of-life care for patients who died of one of ten common cancers diagnosed from 2009 through 2014. Patients were categorized as receiving the majority of their care in an integrated delivery system, designated cancer center, health system that was both integrated and a certified cancer center, or health system that was neither. We evaluated adherence to seven nationally endorsed end-of-life quality measures using generalized linear models across four delivery system types.

resultsAmong 100,549 beneficiaries who died of cancer during the study interval, we identified only modest differences in intensity of end-of-life care across delivery system structures. Health systems with no cancer center or integrated affiliation demonstrated higher proportions of patients with multiple hospitalizations in the last 30 days of life (11.3%), death in an acute care setting (25.9%), and lack of hospice use in the last year of life (31.6%; all

conclusionIntensity of care at the end of life for patients with cancer was higher at delivery systems with no integration or cancer focus. Maximal supportive care delivered through hospice may be one avenue to reduce high-intensity care at the end of life and may impact quality of care for patients dying from cancer.

Indexed as

Hospice CareNeoplasmsTerminal CareAgedDeathHumansMedicareUnited States

Identifiers

PMID32069191
PMCPMC7359774

What OpenQuestion holds

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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.