{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T03:36:14Z","timestamp":1790825774386,"version":"4.1.0"},"reference-count":48,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"5","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncology Practice"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec><jats:title>PURPOSE:<\/jats:title><jats:p>Early palliative care, concomitant with disease-directed treatments, is recommended for all patients with advanced cancer. This study assesses population-level trends in palliative care use among a large cohort of commercially insured patients with metastatic cancer, applying an expanded definition of palliative care services based on claims data.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>Using nationally representative commercial insurance claims data, we identified patients with metastatic breast, colorectal, lung, bronchus, trachea, ovarian, esophageal, pancreatic, and liver cancers and melanoma between 2001 and 2016. We assessed the annual proportions of these patients who received services specified as, or indicative of, palliative care. Using Cox proportional hazard models, we assessed whether the time from diagnosis of metastatic cancer to first encounter of palliative care differed by demographic characteristics, socioeconomic factors, or region.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>In 2016, 36% of patients with very poor prognosis cancers received a service specified as, or indicative of, palliative care versus 18% of those with poor prognosis cancers. Being diagnosed in more recent years (2009-2016 v 2001-2008: hazard ratio [HR], 1.8; P &lt; .001); a diagnosis of metastatic esophagus, liver, lung, or pancreatic cancer, or melanoma ( v breast cancer, eg, esophagus HR, 1.89; P &lt; .001); a greater number of comorbidities (American Hospital Formulary Service classes &gt; 10 v 0: HR, 1.71; P &lt; .001); and living in the Northeast (HR, 1.43; P &lt; .001) or Midwest ( v South: HR, 1.39; P &lt; .001) were the strongest predictors of shorter time from diagnosis to palliative care.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION:<\/jats:title><jats:p>Use of palliative care among commercially insured patients with advanced cancers has increased since 2001. However, even with an expanded definition of services specified as, or indicative of, palliative care, &lt; 40% of patients with advanced cancers received palliative care in 2016.<\/jats:p><\/jats:sec>","DOI":"10.1200\/op.21.00516","type":"journal-article","created":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T20:59:28Z","timestamp":1641416368000},"page":"e677-e687","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":17,"title":["Use of Palliative Care Among Commercially Insured Patients With Metastatic Cancer Between 2001 and 2016"],"prefix":"10.1200","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1572-3581","authenticated-orcid":false,"given":"Alessandra","family":"Ferrario","sequence":"first","affiliation":[{"name":"Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8282-8738","authenticated-orcid":false,"given":"Fang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0066-1242","authenticated-orcid":false,"given":"Dennis","family":"Ross-Degnan","sequence":"additional","affiliation":[{"name":"Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2053-0757","authenticated-orcid":false,"given":"J. Frank","family":"Wharam","sequence":"additional","affiliation":[{"name":"Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1998-3495","authenticated-orcid":false,"given":"Martha L.","family":"Twaddle","sequence":"additional","affiliation":[{"name":"Northwestern Medicine, Feinberg School of Medicine, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1069-6668","authenticated-orcid":false,"given":"Anita K.","family":"Wagner","sequence":"additional","affiliation":[{"name":"Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"b1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.70.1474"},{"key":"b2","volume-title":"Clinical Practice Guidelines for Quality Palliative Care","author":"National Consensus Project for Quality Palliative Care","year":"2018","edition":"4"},{"key":"b3","volume-title":"What is the Difference Between Supportive and Palliative Care?","author":"Lo SS","year":"2021"},{"key":"b4","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.70.5046"},{"key":"b5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1000678"},{"key":"b6","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.32.4459"},{"key":"b7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2015.07.005"},{"key":"b8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01234.x"},{"key":"b9","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2017.020883"},{"key":"b10","first-page":"CD011129","volume":"6","author":"Haun MW","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"b11","volume-title":"Primary Palliative Care","author":"Schenker Y"},{"key":"b12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1215620"},{"key":"b13","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2016.017897"},{"key":"b14","doi-asserted-by":"publisher","DOI":"10.1177\/1049909119852082"},{"key":"b15","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23895"},{"key":"b16","doi-asserted-by":"publisher","DOI":"10.1177\/1049909118809975"},{"key":"b17","doi-asserted-by":"publisher","DOI":"10.1177\/1049909117736750"},{"key":"b18","doi-asserted-by":"publisher","DOI":"10.21037\/jgo.2018.03.08"},{"key":"b19","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2016.0050"},{"key":"b20","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2016.0363"},{"key":"b21","doi-asserted-by":"publisher","DOI":"10.1111\/bju.14708"},{"key":"b22","doi-asserted-by":"publisher","DOI":"10.1200\/OP.20.00298"},{"key":"b23","doi-asserted-by":"publisher","DOI":"10.1089\/jayao.2019.0040"},{"key":"b24","volume-title":"American Community Survey (ACS)","author":"US Census Bureau"},{"key":"b25","doi-asserted-by":"publisher","DOI":"10.1200\/OP.20.00089"},{"key":"b26","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318289c3fb"},{"key":"b27","volume-title":"SEER*Explorer","year":"2021"},{"key":"b28","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/154.9.854"},{"key":"b29","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2018.05026"},{"key":"b30","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.1111\/j.1475-6773.2006.00551.x","volume":"41","author":"Fiscella K","year":"2006","journal-title":"Health Serv Res"},{"key":"b31","volume-title":"Ethnic Technologies Frequently Asked Questions","year":"2019"},{"key":"b32","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.82.5.703"},{"key":"b33","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.93.10.1655"},{"key":"b34","volume-title":"ARIMA","author":"stata.com","year":"2021"},{"key":"b35","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1972.tb00899.x"},{"key":"b36","volume-title":"Stata Statistical Software","author":"StataCorp","year":"2017"},{"key":"b37","volume-title":"Center to Advance Palliative Care and National Palliative Care Research Center: America\u2019s care of serious illness: A state-by-state report card on access to palliative care in our nation\u2019s hospitals, 2019. http:\/\/www.liebertpub.com\/doi\/10.1089\/jpm.2011.9634"},{"key":"b38","unstructured":"ABMS Boards to Offer Certification in Hospice and Palliative Care Medicine. January 16, 2007. New York, NY. https:\/\/www.capc.org\/about\/press-media\/pressreleases\/2007-1-16\/abms-boards-offer-certification-hospice-and-palliative-care-medicine\/"},{"key":"b39","doi-asserted-by":"publisher","DOI":"10.1188\/04.ONF.1105-1117"},{"key":"b40","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-132-6-200003210-00005"},{"key":"b41","volume-title":"Why is it so hard to get home care at the end of life?","author":"Grinberg C","year":"2020"},{"key":"b42","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.19.5.166"},{"key":"b43","volume-title":"Billing for Social Work Services in Palliative Care","author":"CAPC","year":"2020"},{"key":"b44","volume-title":"Serious Illness Care","year":"2021"},{"key":"b45","volume-title":"Palliative Care","year":"2021"},{"key":"b46","volume-title":"Aspire Health","year":"2021"},{"key":"b47","volume-title":"Cambia Palliative Care Center of Excellence","year":"2021"},{"key":"b48","volume-title":"Program Description","author":"Aetna Compassionate Care Program","year":"2021"}],"container-title":["JCO Oncology Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/OP.21.00516","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T11:07:33Z","timestamp":1700046453000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/OP.21.00516"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":48,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1200\/OP.21.00516"],"URL":"https:\/\/doi.org\/10.1200\/op.21.00516","relation":{},"ISSN":["2688-1527","2688-1535"],"issn-type":[{"value":"2688-1527","type":"print"},{"value":"2688-1535","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5]]},"assertion":[{"value":"2021-07-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-25","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}