Previously Funded Research

Amy Davidoff, PhD

Yale University

Research Project:

Patterns of palliative care and concurrent therapy for lung cancer at end-of-life: implications for quality

Summary:

This study will examine patterns of care during the final six months of life for Medicare beneficiaries who died from lung cancer. We will focus on the types of palliative care services received during this period, and the relationship to ongoing cancer-directed treatment, such as chemotherapy or radiation therapy. Palliative care is designed to manage symptoms of cancer and the side effects of treatment, and to reduce emotional distress for patients and families. While hospice has been a key provider of palliative care services, we will assess the extent to which palliative care is provided outside of the hospice setting. Several studies have suggested that early palliative care is associated with more patient-centered and less aggressive treatment at the end-of-life. Our study will examine this issue using a large, population-based dataset that includes almost 30% of Medicare beneficiaries. The results of this study will provide critical information on the current landscape of palliative care receipt and Medicare spending outside of hospice, and receipt of concurrent cancer-directed therapy. This research will allow refinement of quality measures related to end-of-life care. In addition, this research will help to guide development of new approaches to pay for palliative care within the Medicare program.