Table 3.

Factors associated with early referral to palliative care

Variables	3‐level ordinal logistic regression
	Univariable		Multivariable
	OR a (95% CI)	p value	OR a (95% CI)	p value
Age at referral, yr	1.00 (0.99–1.01)	.97
Patient sex
Female	1.45 (1.10–1.91)	.009	1.36 (1.02–1.81)	.04
Male	(reference group)
Tumor site		.09
Breast	3.08 (1.43–6.66)	.004
Central nervous system	1.30 (0.53–3.23)	.57
Gastrointestinal	1.55 (0.79–3.07)	.21
Genitourinary	2.18 (1.04–4.54)	.04
Gynecological	2.12 (1.03–4.39)	.04
Head and neck	1.50 (0.68–3.30)	.31
Hematological	(reference group)
Other b	2.19 (0.99–4.84)	.05
Lung	1.99 (0.98–4.05)	.06
Years since cancer diagnosis
≥2 yr	1.72 (1.30–2.27)	.0002	1.79 (1.34–2.40)	<.0001
<2 yr	(reference group)
Referring oncologist specialty		.09
Hematology	(reference group)
Medical oncology	2.23 (1.11–4.46)	.02
Radiation oncology	1.58 (0.76–3.30)	.22
Surgical oncology	2.18 (0.93–5.08)	.07
Other c	1.64 (0.41–6.63)	.49
Referring oncologist sex
Female	1.02 (0.77–1.35)	.89
Male	(reference group)
Reason for referral		<.0001		.002
Pain/symptom management	2.71 (1.98–3.70)	<.0001	2.02 (1.45–2.82)	.002
Palliative planning	1.33 (0.88–2.02)	.17	1.44 (0.95–2.21)	.94
Palliative planning and pain/symptom management	(reference group)
End‐of‐life care d
Cohort
Post‐evidence	2.77 (2.07–3.71)	<.0001	2.36 (1.72–3.25)	<.0001
Pre‐evidence	(reference group)

^aThree‐level ordinal logistic regressions were performed. Using late referral (≤6 months) as the reference level, an OR > 1 indicated a positive association with an earlier referral.

^bOther tumor sites included skin, sarcoma, endocrine, and unknown primary.

^cOther referring services included psychosocial oncology, internal medicine, anesthesia, and gastroenterology.

^dExcluded from analysis due to small numbers.

Abbreviations: CI, confidence interval; OR, odds ratio.