Impact of palliative care on mortality, length of stay, and hospital charges in common cancers.

Abstract

12087 Background: Palliative care is a vital component of advanced cancer management, offering symptom relief, improved quality of life, and comprehensive care for patients with complex health needs. While its clinical benefits are well-documented, its impact on hospital outcomes—such as in-hospital mortality, length of stay (LOS), and total hospitalization charges (TOTCHG)—remains underexplored across major cancers. Using the 2021 National Inpatient Sample (NIS), this study evaluates the influence of palliative care utilization on these outcomes among hospitalized patients with breast, lung, colon, bladder, and prostate cancers. Methods: This retrospective analysis examined 966,753 weighted hospitalizations, representing breast (163,594), lung (383,215), colon (168,750), bladder (86,555), and prostate (182,280) cancers. Palliative care utilization was the primary exposure. Outcomes assessed included in-hospital mortality, LOS, and TOTCHG. Survey-weighted logistic and linear regression models were used to adjust for patient demographics (age, sex, race, income quartile), comorbidities (Charlson Comorbidity Index, CCI), and hospital characteristics (location, teaching status, region, bed size). Results: The overall mortality rate was 6.6%, highest in lung (9.3%) and lowest in prostate (4.7%) and colon cancers (4.8%). Palliative care patients had higher mortality (28.5%; p < 0.001). Adjusted analyses showed increased mortality with higher CCI (OR = 0.71, p < 0.001) and urban hospitals (OR = 1.40, p < 0.001), while female patients had reduced risk (OR = 0.86, p < 0.001).LOS averaged 5.98 days, longer for palliative care patients (7.68 days; p < 0.001). TOTCHG averaged $83,430, higher for palliative care ($90,488; p < 0.001). Black patients incurred higher charges (+$10,475, p = 0.001), and urban hospitals had lower costs (-$35,094, p < 0.001).Palliative care was concentrated in urban (93.7%) and teaching hospitals (80%), with significant underrepresentation of Black and Hispanic patients in the utilisation of palliative care. (19.2% and 8.8%). Conclusions: Palliative care in hospitalized cancer patients addresses the needs of patients with advanced disease and significant comorbidities. However, the study highlights stark disparities in healthcare access, resource utilization, and demographic representation based on race, socioeconomic status, and hospital characteristics. Palliative care outcomes cancer comparison table. Cancer Type Total Hospitalizations Mortality Rate (%) MeanLOS Mean Hospital Charges Palliative Care Mortality Rate (%) Palliative Care LOS Palliative CareCharges Breast 163594 6.6 7.34 85727 26.4 7.34 85727 Lung 383215 9.3 6.19 82776 30.55 7.53 89760 Colon 168750 4.8 6.62 96148 24.99 8.09 95202 Bladder 86555 4.7 8.33 92731 25.9 8.33 92731 Prostate 182280 4.7 5.41 79410 27.12 7.81 91883