Black patients are less likely than non-Hispanic whites to receive documented end-of-life care during their final hospital stays, according to a new study of New York State hospitals. Racial disparities like this are more pronounced in non-teaching hospitals compared to teaching hospitals.
Researchers analyzed 143,713 terminal hospitalizations across 188 hospitals in New York State from 2016 to 2018. The study, published in the Journal of the American Geriatrics Society, aimed to determine if disparities existed in end-of-life care among minority patients and whether hospital characteristics influenced any identified disparities.
The study focused on two key aspects of end-of-life care: do-not-resuscitate (DNR) status and palliative care encounters. Results showed that Black patients were 17% less likely to have palliative care encounters and 9% less likely to have DNR status compared to non-Hispanic white patients across all hospitals.
Hospital type played a significant role in these end-of-life care disparities. In non-teaching hospitals, all minority groups had decreased odds of receiving palliative care. Black patients were 20% less likely, Hispanic patients were 9% less likely, and other minority groups were 7% less likely to receive palliative care compared to non-Hispanic white patients. In teaching hospitals, only Black patients showed a reduced likelihood of palliative care encounters, being 12% less likely to receive this care.
Meanwhile, Hispanic patients were 7% more likely to have DNR status compared to non-Hispanic white patients across all hospitals. However, Black patients in Black-serving hospitals were 20% less likely to have DNR status.
The availability of specialty palliative care did not significantly affect these disparities.
The study authors highlighted a need for further research into the causes of these disparities and potential interventions to ensure equitable end-of-life care for all patients, regardless of race or ethnicity. The researchers also underscored the importance of considering hospital characteristics when addressing healthcare inequalities.
