Patterns of health care utilization among Medicare beneficiaries diagnosed with pancreatic adenocarcinoma.

Abstract Background Care patterns among patients diagnosed with pancreatic adenocarcinoma remain poorly defined. Methods Cluster analysis was performed on patients with pancreatic adenocarcinoma to assess time from diagnosis to death spent in different care settings (home self-care-dominant[HSC], acute in-hospital care-dominant[ACS], hospice care-dominant[HC] or mixed home and hospice care[MHH]). Results Among 32,816 patients, most belonged to the HSC group (n = 13,459, 41%), followed by MHH (n = 9,091, 28%), ACS (n = 5,737, 18%) and HC (n = 4,529, 14%). Only about 1 in 3 patients in the HSC (n = 4,028, 30%) or ACS (n = 2,206, 35%) received hospice services for at least one week before death. 16% of patients (n = 5,188) died in the hospital, which was most common among ACS patients (n = 1,640, 29%). Median daily expenditures varied according to health care utilization (HSC, $44.6, IQR 12.3–130.1 vs MHH, $162.3, IQR 60.5–351.9 vs ACS, $489.7, IQR 243.2–856.8 vs HC, $306.1, IQR 132.3–580.0; p  Conclusions Pancreatic adenocarcinoma patients differed with regards to health care utilization, hospice use and expenditures following diagnosis.