Sex and Racial/Ethnic Differences in End-of-Life Care in Decedents with Lung Cancer in Texas.

Abstract

The lung cancer five-year survival rate is lower for Texans compared with the national average. We assessed sex and racial/ethnic differences in end-of-life care among decedents with lung cancer in Texas. We used the Texas Cancer Registry with Medicare data for decedents ≥66 years who died six months to five years after diagnosis of lung cancer between 2010 and 2018 and assessed differences in health care utilization, billed advance care planning (ACP), and hospice in the last 30 days of life. Multivariable logistic regression models were used to assess differences in odds of inpatient admission and hospice. Males had more health care utilization and less hospice enrollment. Multivariable logistic regression models confirmed that males had lower odds of hospice enrollment. Non-Hispanic Blacks and Hispanics had more health care utilization and less hospice enrollment, confirmed by multivariable logistic regression models. Billed ACP was low across all groups. Texan males, non-Hispanic Blacks, and Hispanics had greater health care utilization and less hospice enrollment.