No significant racial differences exist in the quality of end-of-life care in the United States, but the overall quality of this care does require improvement, according to a study published in JAMA Internal Medicine.
Researchers sought to determine whether racial differences exist in end-of-life care by evaluating survey results recorded in the National Health and Aging Trends Study. The investigators compared interview data from primarily black and white patients at end of life.
A total of 1106 interviews were administered to a family member of a decedent. According to the results of the interviews, black patients had a higher chance for dying in the intensive care unit of the hospital than white patients, and more white decedents used hospice services in their last month of life than black decedents. Family members responding for white decedents were more likely to report that the patient was not consistently treated with respect compared with those responding for black patients (16.8% vs 11.3%; P =.02).
Family members of both white and black decedents equally reported not always being informed on the decedent’s care or progress. More respondents for white decedents than black decedents commented that decisions in care did not always meet the patient’s wishes (13.7% vs 10.4%), and input from the patient in clinical decision making was considered insufficient among both white and black family members (10.1% vs 8.2%, respectively).
The investigators note that they excluded patients whose surveys were completed by nonfamilial staff in residential care centers, which may have limited the researchers’ ability to “capture racial differences in the quality of end-of-life care for those individuals.”
Sharma RK, Freedman VA, Mor V, Kaspar JD, Gozalo P, Teno JM. Association of racial differences with end-of-life care quality in the United States [published online October 9, 2017]. JAMA Intern Med. doi: 10.1001/jamainternmed.2017.4793