The Impact of Advanced Care Planning on Hospice Utilization in Patients with Cancer: A Nationwide Analysis in Korea

Abstract

Background: Hospice and palliative care play key roles in facilitating goals-of-care discussions and managing symptoms in end-of-life (EOL) care for cancer patients. In this study, the association between completion of advance care planning (ACP), which refers to decisions regarding life-sustaining treatment, and hospice utilization in patients with cancer is examined. Methods: Data from the Korea-Clinical Data Utilization Network for Research Excellence were used. The study population included individuals diagnosed with one of the five leading causes of cancer-related deaths in South Korea. The association between the completion of ACP and hospice utilization was analyzed using multivariable logistic regression analysis. Results: The study population included 50,574 patients with terminal cancer, of whom 10,530 (20.8%) had received hospice care. Self-determined ACP was completed by 9271 (18.3%) participants and non-self-determined ACP by 8654 (17.1%). Patients with ACP were more likely to receive hospice care, with the self-determined group (OR, 5.46; 95% CI: 5.13–5.81) showing a stronger association than the non-self-determined group (OR, 1.27; 95% CI: 1.18–1.37). Conclusions: Patients with cancer who completed ACP were more likely to use hospice care services. These findings indicate the potential importance of ACP decisions in providing EOL care.