Racial/Ethnic Differences in Inpatient Palliative Care Consultation for Patients With Advanced Cancer. Academic Article uri icon

Overview

MeSH

  • Adult
  • Aged
  • Confounding Factors (Epidemiology)
  • Diagnosis-Related Groups
  • Female
  • Humans
  • Insurance, Health
  • Kaplan-Meier Estimate
  • Male
  • Medical Records
  • Middle Aged
  • Retrospective Studies
  • United States

MeSH Major

  • African Americans
  • European Continental Ancestry Group
  • Hispanic Americans
  • Hospice Care
  • Inpatients
  • Palliative Care

abstract

  • Inpatient palliative care consultation (IPCC) may help address barriers that limit the use of hospice and the receipt of symptom-focused care for racial/ethnic minorities, yet little is known about disparities in the rates of IPCC. We evaluated the association between race/ethnicity and rates of IPCC for patients with advanced cancer. Patients with metastatic cancer who were hospitalized between January 1, 2009, and December 31, 2010, at an urban academic medical center participated in the study. Patient-level multivariable logistic regression was used to evaluate the association between race/ethnicity and IPCC. A total of 6,288 patients (69% non-Hispanic white, 19% African American, and 6% Hispanic) were eligible. Of these patients, 16% of whites, 22% of African Americans, and 20% of Hispanics had an IPCC (overall P < .001). Compared with whites, African Americans had a greater likelihood of receiving an IPCC (odds ratio, 1.21; 95% CI, 1.01 to 1.44), even after adjusting for insurance, hospitalizations, marital status, and illness severity. Among patients who received an IPCC, African Americans had a higher median number of days from IPCC to death compared with whites (25 v 17 days; P = .006), and were more likely than Hispanics (59% v 41%; P = .006), but not whites, to be referred to hospice. Inpatient settings may neutralize some racial/ethnic differences in access to hospice and palliative care services; however, irrespective of race/ethnicity, rates of IPCC remain low and occur close to death. Additional research is needed to identify interventions to improve access to palliative care in the hospital for all patients with advanced cancer. © 2015 by American Society of Clinical Oncology.

publication date

  • November 10, 2015

has subject area

  • Adult
  • African Americans
  • Aged
  • Confounding Factors (Epidemiology)
  • Diagnosis-Related Groups
  • European Continental Ancestry Group
  • Female
  • Hispanic Americans
  • Hospice Care
  • Humans
  • Inpatients
  • Insurance, Health
  • Kaplan-Meier Estimate
  • Male
  • Medical Records
  • Middle Aged
  • Palliative Care
  • Retrospective Studies
  • United States

Research

keywords

  • Journal Article

Identity

Language

  • eng

PubMed Central ID

  • PMC4979133

Digital Object Identifier (DOI)

  • 10.1200/JCO.2015.61.6458

PubMed ID

  • 26324373

Additional Document Info

start page

  • 3802

end page

  • 3808

volume

  • 33

number

  • 32