Table 2. Open in new tab Demographic-,...

Variable

Multivariable OR for hospice enrollment (95% CI)

P^¶

Multivariable OR for late hospice enrollment* (95% CI)

P^¶

Age quintiles, y

66–69

1.00 (Referent)

70–72

1.02 (0.96 to 1.09)

.49

1.03 (0.95 to 1.10)

.50

73–76

1.04 (0.98 to 1.10)

.24

0.93 (0.87 to 1.00)

.04

77–81

1.00 (0.94 to 1.06)

.94

0.97 (0.91 to 1.04)

.44

82–104

1.19 (1.12 to 1.27)

<.001

0.90 (0.83 to 0.96)

.003

Sex

Female

1.00 (Referent)

Male

0.78 (0.74 to 0.81)

<.001

1.36 (1.29 to 1.43)

<.001

Race/Ethnicity

White

1.00 (Referent)

Black

0.76 (0.71 to 0.82)

<.001

0.97 (0.89 to 1.06)

.54

Hispanic

0.80 (0.72 to 0.87)

<.001

0.85 (0.76 to 0.96)

.007

Asian

0.52 (0.48 to 0.57)

<.001

0.82 (0.72 to 0.93)

.002

Other or unknown

0.87 (0.63 to 1.18)

.36

1.19 (0.83 to 1.70)

.35

Marital status

Single

1.00 (Referent)

Married

1.03 (0.99 to 1.07)

.19

1.06 (1.01 to 1.11)

.03

Unknown

1.09 (0.99 to 1.21)

.08

1.14 (1.02 to 1.26)

.02

Residence

Rural

1.00 (Referent)

Urban

1.10 (1.02 to 1.18)

.02

1.11 (1.02 to 1.21)

.02

Unknown

0.86 (0.78 to 1.06)

.19

0.92 (0.81 to 1.03)

.14

Zip-code level household income, per US $10 000 increase^†

0.98 (0.97 to 0.99)

<.001

1.01 (1.00 to 1.02)

.22

Zip-code level high school graduates, per percent increase^†

1.01 (1.01 to 1.01)

<.001

1.00 (1.00 to 1.00)

.67

Primary cancer site^‡

Lung cancer

1.00 (Referent)^§

Breast cancer

1.04 (0.97 to 1.12)

.25

1.05 (0.98 to 1.14)

.19

Melanoma

1.24 (1.14 to 1.35)

<.001

1.05 (0.96 to 1.15)

.26

Renal cancer

0.99 (0.89 to 1.10)

.83

0.89 (0.79 to 1.01)

.06

Colorectal cancer

1.07 (0.98 to 1.17)

.13

0.84 (0.76 to 0.93)

.001

Ovarian cancer

1.44 (1.13 to 1.82)

.003

0.90 (0.71 to 1.14)

.39

Esophageal cancer

1.26 (1.04 to 1.51)

.02

1.00 (0.82 to 1.22)

1.00

Other

1.04 (0.97 to 1.12)

.28

1.04 (0.96 to 1.14)

.33

Charlson Comorbidity Index

0–2

1.00 (Referent)

≥3

0.90 (0.84 to 0.96)

.001

1.23 (1.14 to 1.32)

<.001

Unknown

0.95 (0.90 to 1.00)

.07

0.95 (0.89 to 1.01)

.08

Received care at a medical school–affiliated hospital^‖

1.00 (Referent)

Yes

1.02 (0.98 to 1.07)

.28

0.94 (0.89 to 0.98)

.009

Received care at an urban hospital^‖

1.00 (Referent)

Yes

0.99 (0.92 to 1.06)

.73

1.07 (0.99 to 1.16)

.11

Unknown

0.91 (0.84 to 1.06)

.23

0.96 (0.87 to 1.07)

.47

Received care at a government hospital^‖

1.00 (Referent)

Yes

1.07 (1.03 to 1.12)

.002

0.93 (0.89 to 0.98)

.007

Table 2.

Open in new tab

Demographic-, clinical-, and hospital-related predictors of hospice utilization and late hospice enrollment (length of stay <7 days vs ≥7 days before death) among patients with brain metastases

Variable	Multivariable OR for hospice enrollment (95% CI)	P^¶	Multivariable OR for late hospice enrollment* (95% CI)	P^¶
Age quintiles, y
66–69	1.00 (Referent)		1.00 (Referent)
70–72	1.02 (0.96 to 1.09)	.49	1.03 (0.95 to 1.10)	.50
73–76	1.04 (0.98 to 1.10)	.24	0.93 (0.87 to 1.00)	.04
77–81	1.00 (0.94 to 1.06)	.94	0.97 (0.91 to 1.04)	.44
82–104	1.19 (1.12 to 1.27)	<.001	0.90 (0.83 to 0.96)	.003
Sex
Female	1.00 (Referent)		1.00 (Referent)
Male	0.78 (0.74 to 0.81)	<.001	1.36 (1.29 to 1.43)	<.001
Race/Ethnicity
White	1.00 (Referent)		1.00 (Referent)
Black	0.76 (0.71 to 0.82)	<.001	0.97 (0.89 to 1.06)	.54
Hispanic	0.80 (0.72 to 0.87)	<.001	0.85 (0.76 to 0.96)	.007
Asian	0.52 (0.48 to 0.57)	<.001	0.82 (0.72 to 0.93)	.002
Other or unknown	0.87 (0.63 to 1.18)	.36	1.19 (0.83 to 1.70)	.35
Marital status
Single	1.00 (Referent)		1.00 (Referent)
Married	1.03 (0.99 to 1.07)	.19	1.06 (1.01 to 1.11)	.03
Unknown	1.09 (0.99 to 1.21)	.08	1.14 (1.02 to 1.26)	.02
Residence
Rural	1.00 (Referent)		1.00 (Referent)
Urban	1.10 (1.02 to 1.18)	.02	1.11 (1.02 to 1.21)	.02
Unknown	0.86 (0.78 to 1.06)	.19	0.92 (0.81 to 1.03)	.14
Zip-code level household income, per US $10 000 increase^†	0.98 (0.97 to 0.99)	<.001	1.01 (1.00 to 1.02)	.22
Zip-code level high school graduates, per percent increase^†	1.01 (1.01 to 1.01)	<.001	1.00 (1.00 to 1.00)	.67
Primary cancer site^‡
Lung cancer	1.00 (Referent)^§		1.00 (Referent)^§
Breast cancer	1.04 (0.97 to 1.12)	.25	1.05 (0.98 to 1.14)	.19
Melanoma	1.24 (1.14 to 1.35)	<.001	1.05 (0.96 to 1.15)	.26
Renal cancer	0.99 (0.89 to 1.10)	.83	0.89 (0.79 to 1.01)	.06
Colorectal cancer	1.07 (0.98 to 1.17)	.13	0.84 (0.76 to 0.93)	.001
Ovarian cancer	1.44 (1.13 to 1.82)	.003	0.90 (0.71 to 1.14)	.39
Esophageal cancer	1.26 (1.04 to 1.51)	.02	1.00 (0.82 to 1.22)	1.00
Other	1.04 (0.97 to 1.12)	.28	1.04 (0.96 to 1.14)	.33
Charlson Comorbidity Index
0–2	1.00 (Referent)		1.00 (Referent)
≥3	0.90 (0.84 to 0.96)	.001	1.23 (1.14 to 1.32)	<.001
Unknown	0.95 (0.90 to 1.00)	.07	0.95 (0.89 to 1.01)	.08
Received care at a medical school–affiliated hospital^‖
No	1.00 (Referent)		1.00 (Referent)
Yes	1.02 (0.98 to 1.07)	.28	0.94 (0.89 to 0.98)	.009
Received care at an urban hospital^‖
No	1.00 (Referent)		1.00 (Referent)
Yes	0.99 (0.92 to 1.06)	.73	1.07 (0.99 to 1.16)	.11
Unknown	0.91 (0.84 to 1.06)	.23	0.96 (0.87 to 1.07)	.47
Received care at a government hospital^‖
No	1.00 (Referent)		1.00 (Referent)
Yes	1.07 (1.03 to 1.12)	.002	0.93 (0.89 to 0.98)	.007

Variable	Multivariable OR for hospice enrollment (95% CI)	P^¶	Multivariable OR for late hospice enrollment* (95% CI)	P^¶
Age quintiles, y
66–69	1.00 (Referent)		1.00 (Referent)
70–72	1.02 (0.96 to 1.09)	.49	1.03 (0.95 to 1.10)	.50
73–76	1.04 (0.98 to 1.10)	.24	0.93 (0.87 to 1.00)	.04
77–81	1.00 (0.94 to 1.06)	.94	0.97 (0.91 to 1.04)	.44
82–104	1.19 (1.12 to 1.27)	<.001	0.90 (0.83 to 0.96)	.003
Sex
Female	1.00 (Referent)		1.00 (Referent)
Male	0.78 (0.74 to 0.81)	<.001	1.36 (1.29 to 1.43)	<.001
Race/Ethnicity
White	1.00 (Referent)		1.00 (Referent)
Black	0.76 (0.71 to 0.82)	<.001	0.97 (0.89 to 1.06)	.54
Hispanic	0.80 (0.72 to 0.87)	<.001	0.85 (0.76 to 0.96)	.007
Asian	0.52 (0.48 to 0.57)	<.001	0.82 (0.72 to 0.93)	.002
Other or unknown	0.87 (0.63 to 1.18)	.36	1.19 (0.83 to 1.70)	.35
Marital status
Single	1.00 (Referent)		1.00 (Referent)
Married	1.03 (0.99 to 1.07)	.19	1.06 (1.01 to 1.11)	.03
Unknown	1.09 (0.99 to 1.21)	.08	1.14 (1.02 to 1.26)	.02
Residence
Rural	1.00 (Referent)		1.00 (Referent)
Urban	1.10 (1.02 to 1.18)	.02	1.11 (1.02 to 1.21)	.02
Unknown	0.86 (0.78 to 1.06)	.19	0.92 (0.81 to 1.03)	.14
Zip-code level household income, per US $10 000 increase^†	0.98 (0.97 to 0.99)	<.001	1.01 (1.00 to 1.02)	.22
Zip-code level high school graduates, per percent increase^†	1.01 (1.01 to 1.01)	<.001	1.00 (1.00 to 1.00)	.67
Primary cancer site^‡
Lung cancer	1.00 (Referent)^§		1.00 (Referent)^§
Breast cancer	1.04 (0.97 to 1.12)	.25	1.05 (0.98 to 1.14)	.19
Melanoma	1.24 (1.14 to 1.35)	<.001	1.05 (0.96 to 1.15)	.26
Renal cancer	0.99 (0.89 to 1.10)	.83	0.89 (0.79 to 1.01)	.06
Colorectal cancer	1.07 (0.98 to 1.17)	.13	0.84 (0.76 to 0.93)	.001
Ovarian cancer	1.44 (1.13 to 1.82)	.003	0.90 (0.71 to 1.14)	.39
Esophageal cancer	1.26 (1.04 to 1.51)	.02	1.00 (0.82 to 1.22)	1.00
Other	1.04 (0.97 to 1.12)	.28	1.04 (0.96 to 1.14)	.33
Charlson Comorbidity Index
0–2	1.00 (Referent)		1.00 (Referent)
≥3	0.90 (0.84 to 0.96)	.001	1.23 (1.14 to 1.32)	<.001
Unknown	0.95 (0.90 to 1.00)	.07	0.95 (0.89 to 1.01)	.08
Received care at a medical school–affiliated hospital^‖
No	1.00 (Referent)		1.00 (Referent)
Yes	1.02 (0.98 to 1.07)	.28	0.94 (0.89 to 0.98)	.009
Received care at an urban hospital^‖
No	1.00 (Referent)		1.00 (Referent)
Yes	0.99 (0.92 to 1.06)	.73	1.07 (0.99 to 1.16)	.11
Unknown	0.91 (0.84 to 1.06)	.23	0.96 (0.87 to 1.07)	.47
Received care at a government hospital^‖
No	1.00 (Referent)		1.00 (Referent)
Yes	1.07 (1.03 to 1.12)	.002	0.93 (0.89 to 0.98)	.007

Among patients enrolled in hospice. CI = confidence interval; OR = odds ratio.

†

Median household income and high school graduates were obtained by linking patient zip codes to information from the 2000 US Census and the 2008–2012 America Community Survey.

‡

First cancer type was used for patients with multiple primary tumors.

Lung cancer was used as the reference group because of the highest prevalence in the study cohort.

‖

Within 1 year of date of death.

Multivariable regression analysis was used. P values are 2-sided.

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