Pattern and Predictors of Outpatient Palliative Care Referral Among Thoracic Medical Oncologists

Abstract

Background. There is significant variation in access to palliative care. We examined the pattern of outpatient palliative care referral among thoracic medical oncologists and identified oncologist characteristics associated with greater referral. Materials and Methods. We retrieved data on all patients who died of advanced thoracic malignancies at our institution between January 1, 2007, and December 31, 2012. Using median as a cutoff, we defined two groups (high-referring and low-referring oncologists) based on their frequency of referral. We examined various oncologist-and patient-related characteristics associated with outpatient referral. Results. Of 1,642 decedents, 444 (27%) had an outpatient palli-ative care referral. The median proportion of referral among 26 thoracic oncologists was 30% (range 9%-45%; median proportion of high-referring 37% vs. low-referring 24% when divided into two groups at median). High-referring oncologists were