Racial Disparities in End-of-Life Care Between Black and White Adults With Metastatic Cancer.
Neoplasms
minority health
palliative medicine
racism
terminal care
Journal
Journal of pain and symptom management
ISSN: 1873-6513
Titre abrégé: J Pain Symptom Manage
Pays: United States
ID NLM: 8605836
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
10
05
2020
revised:
27
08
2020
accepted:
09
09
2020
pubmed:
19
9
2020
medline:
24
6
2021
entrez:
18
9
2020
Statut:
ppublish
Résumé
The comfort of patients with cancer near the end of life (EOL) is often undermined by unnecessary and burdensome treatments. There is a need for more research examining racial disparities in EOL care, especially in regions with a history of racial discrimination. To examine whether black adults received more burdensome EOL care than white adults in a population-based data set of cancer decedents in Louisiana, a state with a history of slavery and long-standing racial disparities. This was a retrospective analysis of EOL care from the Research Action for Health Network (REACHnet), a regional Patient-Centered Outcomes Research Institute-funded database. The sample consisted of 875 white and 415 black patients with metastatic cancer who died in Louisiana from 2011 to 2017. We used logistic regression to examine whether race was associated with five indicators of burdensome care in the last 30 days of life: chemotherapy use, inpatient hospitalization, intensive care unit admission, emergency department (ED) admission, and mechanical ventilation. Most patients (85.0%) received at least one indicator of burdensome care: hospitalization (76.5%), intensive care unit admission (44.1%), chemotherapy (29.1%), mechanical ventilation (23.0%), and ED admission (18.3%). Odds ratios (ORs) indicated that black individuals were more likely than white individuals to be hospitalized (OR = 1.66; 95% CI = 1.21-2.28; P = 0.002) or admitted to the ED (OR = 1.57; 95% CI = 1.16-2.13; P = 0.004) during their last month of life. Findings have implications for informing health care decision making near the EOL for patients, families, and clinicians, especially in regions with a history of racial discrimination and disparities.
Identifiants
pubmed: 32947018
pii: S0885-3924(20)30744-2
doi: 10.1016/j.jpainsymman.2020.09.017
pmc: PMC8100959
mid: NIHMS1629451
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
342-349.e1Subventions
Organisme : NIGMS NIH HHS
ID : U54 GM104940
Pays : United States
Organisme : NIMHD NIH HHS
ID : U54 MD007595
Pays : United States
Informations de copyright
Copyright © 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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