Black patients in the United States are consistently more likely to seek invasive end-of-life treatment and less likely to request hospice care than white patients, investigators say.
The findings hold true despite an overall increase in hospice care use nationwide, reported study co-author David L. Roth, Ph.D., director of the Johns Hopkins Center on Aging and Health, Baltimore.
“What’s unique about our study is that we show this disparity is persistent — not decreasing over time — and appears to be fairly general because it is not specific to a few diseases such as cancer,” he said.
Instead, Black patients seek substantially more intensive treatment in the last six months of life. This includes mechanical ventilation, gastrostomy tube insertion, hemodialysis, cardiopulmonary resuscitation and multiple emergency room visits. White patients more often choose hospice services.
This care gap may impact the quality of Black and white Americans’ end-of-life experiences, the researchers said.
“Despite tremendous growth in palliative care and hospice use in the United States, our work highlights a pressing need to address racial disparities in end-of-life care,” said the study’s lead author, Katherine Ornstein, Ph.D., M.P.H., professor of geriatrics and palliative medicine at Mount Sinai’s Icahn School of Medicine in New York.
The researchers recommend that sustained efforts be made to better educate and train healthcare providers to promote the discussion of personal values and treatment preferences for the end of life in Black populations.
The study was published in JAMA Network Open.
