Race and ethnicity appear to have an effect on whether a patient with terminal cancer uses hospice care services, according to a study published in the January issue of the Journal of the American Geriatrics Society, Reuters Health reports. Researchers, led by Alexander Smith of Boston, Mass.-based Beth Israel Deaconess Medical Center, examined about 41,000 U.S. Medicare beneficiaries ages 65 and older with terminal cancer. They found that black and Asian-American patients were less likely than white or Hispanic patients to be enrolled in a hospice care program.
Compared with whites, black patients were 9% less likely to enroll in a hospice program and Asian-Americans were 24% less likely, according to the study. Black and Asian patients also were 26% and 17% more likely, respectively, to be hospitalized in an intensive care unit at least twice during their last month of life. The two groups also were less likely than Hispanics to die while hospitalized. The racial disparities remained even when researchers took into account possible contributing factors such as income and physical health, Reuters Health reports.
Previous studies have found that black patients are less likely than their white counterparts to use hospice care and more likely to prefer more aggressive end-of-life care that treats their terminal condition. Little is known about the preferences of Asian-Americans, Reuters Health reports. Researchers suggested further investigation into personal preferences for care and access to care. "Improved understanding will hopefully lead to interventions that improve end-of-life care for all patients with advanced cancer," they said (Reuters Health, 1/30).
An abstract of the study is available online.
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