Cancer care in the United States: Identifying end-of-life cohorts

Ethan M. Berke, Tenbroeck Smith, Yunjie Song, Michael T. Halpern, David C. Goodman

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Objectives: End-of-life care is increasingly recognized as an important part of cancer management for many patients. Current methods to measure end-of-life care are limited by difficulties in identifying cancer cohorts with administrative data. We examined several techniques of identifying end-of-life cancer cohorts with claims data that is population-based, geographically scalable, and amenable to routine updating. Methods: Using Medicare claims for patients 65 years of age and older, four techniques for identifying end-of-life cancer cohorts were compared; one based on Part A data using a broad primary or narrow secondary diagnosis of cancer, two based on Part B data, and one combining the Part A and B methods. We tested the performance of each definition to ascertain an appropriate end-of-life cancer population. Results: The combined Part A and B definition using a primary or secondary diagnosis of cancer within a window of 180 days prior to death appears to be the most accurate and inclusive in ascertaining an end-of-life cohort (78.7% attainment). Conclusion: Combining inpatient and outpatient claims data, and identifying cases based upon a broad primary or a narrow secondary cancer definition is the most accurate and inclusive in ascertaining an end-of-life cohort.

Original languageEnglish (US)
Pages (from-to)128-132
Number of pages5
JournalJournal of Palliative Medicine
Issue number2
StatePublished - Feb 1 2009
Externally publishedYes

ASJC Scopus subject areas

  • Nursing(all)
  • Anesthesiology and Pain Medicine


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