Associations in Inpatient Palliative Care Consultation Among Oncology Patients at Community and Academic Hospitals: A Retrospective Cohort Study

BackgroundPalliative care consultation (PCC) improves quality of life for patients with cancer, yet access and delivery vary across hospital settings.ObjectiveThe objective of the study is to examine sociodemographic, clinical, and palliative consult characteristics among oncology inpatients receiving PCCs across community hospitals and academic medical centers.MethodsWe conducted a retrospective cohort study of 961 oncology inpatients who received PCC at five hospitals within a single academic health system (2022-2024). Data were extracted from electronic health records and PCC service metrics. Logistic regression compared predictors of PCC delivery between community hospitals and academic medical centers.ResultsAmong 961 patients, substantial differences by hospital type emerged. Patients receiving PCC at academic centers were more likely to be younger, male, Black or African American, and to have private insurance (<i>P</i> < .05). Other malignancies were more commonly managed with PCC in academic settings (<i>P</i> < .05). Academic medical centers more frequently addressed symptom management and patient or family support, whereas community hospitals more often focused on goals of care discussions.ConclusionThese findings demonstrate significant differences in PCC delivery associated with hospital type, despite shared service line structures. Understanding how site-level factors influence PCC delivery may guide targeted strategies to ensure timely and comprehensive palliative care for oncology inpatients across different care environments.