期刊
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
卷 61, 期 2, 页码 342-+出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jpainsymman.2020.09.017
关键词
Neoplasms; minority health; racism; terminal care; palliative medicine
资金
- Louisiana Clinical and Translational Science Center
- National Institute of General Medical Sciences [U54GM104940]
- National Institute on Minority Health and Health Disparities [U54MD007595]
The study examined end-of-life care for 875 white and 415 black cancer patients in Louisiana from 2011 to 2017, finding that black patients were more likely to be hospitalized and admitted to the emergency department in the last 30 days of life.
Context. 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. Objectives. 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. Methods. 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. Results. 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. Conclusion. 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. (C) 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据