Eli's Hospice Insider

Published on Tue Dec 11, 2012 PDF

Payment policies create barriers to palliative care benefits.

Cancer patients could benefit more from hospice care if their physicians didn’t wait so long to make referrals, says a new Canadian study published in the Journal of Clinical Oncology.

Oncologists referred patients frequently to palliative care, "but generally late in the disease course for patients with uncontrolled symptoms," notes the study’s abstract appearing in the November issue. About a third of surveyed oncologists said they refer patients to palliative care, or hospice, when they diagnose a cancer that has spread and therefore usually is incurable. But another third said they wait until chemotherapy has been stopped, which is often just a few months or even weeks away from death.

"Despite guidelines to refer early, many studies have shown that palliative still happens too late, in the last few months of life," study head Dr. Camilla Zimmermann of Princess Margaret Hospital in Toronto told Reuters.

"The palliative care specialists and oncologists need to work more in collaboration," Zimmerman said. However, in the U.S., Medicare and other insurers generally prohibit coverage of hospice until chemo has ceased, which is a barrier to early referral, she acknowledged.

The abstract is at http://jco.ascopubs.org/content/early/2012/10/29/JCO.2012.44.0248.abstract.