Disparities Associated With Inpatient Palliative Care Utilization by Patients With Metastatic Gynecologic Cancers: A Study of 3337 Women

Objective:To determine the factors associated with inpatient palliative care (PC) use in patients with metastatic gynecologic cancer.Methods:Data were obtained from the Nationwide Inpatient Sample (NIS) for patients with metastatic cervical, uterine, and ovarian cancers. Chi-square and multivariate models were used for statistical analyses.Results:Of 67 947 inpatients with metastatic gynecologic cancer, 3337 (5%) utilized PC (median age: 63 years, range: 18-102 years). For the entire cohort, the majority was white (59%) and the remainder was black (10%), Hispanic (8%), and Asian (3%). Sixty-one percent had ovarian, 25% uterine, and 14% cervical cancers. Forty-four percent had Medicare, 37% private insurance, 12% Medicaid, and 3% were uninsured. Fifty-three percent of patients were treated at teaching hospitals, while 33% were treated at nonteaching hospitals. In multivariate analysis, the use of PC was associated with older age (≥63, median; odds ratio [OR] = 1.52, 95% confidence interval [CI]: 1.36-1.70;...