Integrated supportive oncology program and outcomes for cancer patients at the end of life.

240 Background: Patients with advanced cancer are often exposed to acute medical care that does not improve quality of life or restore health. Further, the cost of care during the terminal phase defined as the last 30 days of life is substantially higher with the vast majority related to acute care services. We established an integrated outpatient supportive oncology service to improve quality of life for patients with advanced cancer. The embedded program provides same day access, longitudinal symptom management, and advanced care planning services. Here, we looked at our institutional outcomes of those patients managed by the integrated supportive oncology program. Methods: A retrospective cohort analysis was performed on patients with metastatic cancer treated at Intermountain Medical Center who died between January 1, 2022 and December 31, 2022. The study population included patients who were seen in the integrated supportive oncology clinic. Hospitalizations, length of stay, and deaths in the hospital during the last 30 days of life were recorded. We used Medicare and commercial insurance claims data to calculate the cost of these end-of-life hospitalizations. Results: Of 164 patients with cancer who died in 2022, 111 (67%) received longitudinal care from the supportive oncology clinic. Hospitalization rate in the last 30 days of life was lower in the study population compared to the control cohort (26% vs 50%) as were in-hospital deaths (7% vs 19%). The median cost of an end-of-life hospitalization was $20,648. Conclusions: An integrated supportive oncology service decreases the rates of end of life hospitalizations and in-hospital deaths for patients with advanced cancer. This is associated with a cost savings.