Trends and racial disparities in palliative care utilization among patients with prostate cancer: A ten-year retrospective study.

12068 Background: Due to improvements in cancer therapies and treatment strategies, survivorship among patients with prostate cancer continues to increase, thus necessitating the utilization of palliative care services for symptom management. We examined the prevalence, trends and predictors of palliative care utilization among hospitalized prostate cancer patients in the US. Methods: A retrospective longitudinal study using the Nationwide Inpatient Sample (NIS) database (2010-2019) was conducted. Using join point regression and multivariable logistic regression, trends and factors associated with palliative care receipt were assessed. Results: The overall prevalence of palliative care utilization in the cohort of over 2 million admissions with prostate cancer, was 5.3%. Over the decade, there was a significant increase in palliative care consultations from 2,970 to 7,509 per 100,000 prostate cancer hospitalizations (p-trend <0.001) with an average annual percentage change of 7.7% over the study period. Individuals ≥70 years with prostate cancer had higher odds (aOR): 1.06; 95% CI: 1.01-1.12) of receiving palliative care relative to those < 70 years. Compared to non-Hispanic whites, non-Hispanic blacks were less likely to receive palliative care services (aOR: 0.93; 95% CI: 0.88-0.98). Patients on Medicaid (aOR: 1.51; 95% CI: 1.38-1.65), private insurance (aOR: 1.3; 95% CI: 1.23-1.38) and other insurance types (aOR: 2.2; 95% CI: 1.85-2.55) had higher odds of palliative care utilization when compared to those on Medicare. Prostate cancer patients discharged to facilities or with home health care were more likely (aOR: 6.4; 95% CI: 6.03-6.8) to receive palliative care. Other factors associated with palliative care receipt were non-elective admissions, admission to urban, large and teaching facilities. Furthermore, longer length of hospital stays (≥5 days vs <5 days) was associated with higher utilization of palliative care (aOR: 1.08; 95% CI: 1.05-1.13). Conclusions: Though the trends in palliative care utilization have improved over the years, it remains suboptimal. Additionally, black patients were less likely to receive palliative care. Further studies are needed to explain these disparities and generate interventions to narrow the identified gaps. Addressing the highlighted sociodemographic and hospital-level disparities will ensure optimal utilization of palliative care in this patient population.Table: see text