title: Documentation of information and care planning for patients with advanced cancer: associations with patient characteristics and utilization of hospital care.
abstract: OBJECTIVE
  We evaluated the association between patient characteristics, utilization of care, and documentation of information and care planning.
  
  
  METHODS
  We abstracted chart documentation for 238 deceased patients with advanced cancer.
  
  
  RESULTS
  Do-not-resuscitate (DNR) orders were documented in 34% of charts, advance directives in 19%, hospice discussion in 49%, and hospice referral in 36%. Compared to white patients, black patients had a higher odds of hospice discussion (Adjusted Odds Ratio [AOR] 2.11; 95% CI 1.18 to 3.76) and hospice referral (AOR 2.18; 95% CI 1.21 to 3.93). Documentation of advance directive and DNR order was associated with higher utilization of care.
  
  
  CONCLUSIONS
  Black race was associated with higher odds of hospice discussion and referral in a primarily Medicaid population. Additional research is needed to explore variations in physician-patient discussion about hospice among different patient populations.
authors: Division of Hospital Medicine, Northwestern University, Chicago, IL 60611, USA. rasharma@nmh.org
authors: Rashmi K
authors: RK
authors: Sharma
authors: Sydney M
authors: SM
authors: Dy
mesh_terms: D032722:Advance Care Planning / Q000592:standards / Q000706:statistics & numerical data*; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D015142:Baltimore; D003142:Communication; D004282:Documentation / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D017051:Hospice Care / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health / Q000145:classification / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009369:Neoplasms / Q000208:ethnology* / Q000473:pathology; D057240:Patient Preference / Q000208:ethnology / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D012189:Retrospective Studies; D044465:White People / Q000706:statistics & numerical data