Health Insurance and End-of-Life Care for People with Hematologic Malignancies
Oreofe Odejide
MDDana-Farber Cancer Institute
Project Term: June 1, 2023 - May 31, 2026
Patients with blood cancers from racial and ethnic minority groups are more likely to experience suboptimal end-of-life (EOL) care. These disparities may be partially driven by health insurance differences but there is limited research examining insurance access as a potential contributor to EOL care disparities for this population. We will leverage complementary local and national datasets to assess the relationship between insurance status and type with EOL quality measures. We will also develop a Blood Cancer Health Insurance Initiative to translate our research findings to policy initiatives to dismantle disparities in access to high-quality EOL care for patients with blood cancers. We will translate our research findings to policy initiatives to dismantle disparities in access to high-quality EOL care for patients with blood cancers.
Timely hospice use and avoiding overly intensive care are essential components of quality end-of-life (EOL) care. Research suggests that patients with blood cancer, and especially those from racial and ethnic minority groups, are more likely to receive sub-optimal EOL care. While some data has suggested that barriers related to insurance access and type contribute to worse quality of EOL care among blood cancer patients, this relationship needs to be better understood, particularly among patients from racial and ethnic minority groups who may experience greater adverse impact. Using data from a cohort of blood cancer patients at Dana Farber Cancer Institute as well as a national research database, this project seeks to characterize the relationship between insurance status and type with EOL care quality, to develop actionable recommendations to promote equity in access to high-quality EOL care. The findings may provide evidence to guide policy interventions to expand high-quality EOL care.