While inpatient settings may be able to neutralize possible racial/ethnic differences in access to hospice and palliative care services, rates of inpatient palliative care consultation remain low and occur close to death irrespective of race/ethnicity, according to a recent study published online ahead of print in the Journal of Clinical Oncology.1
Researchers led by Rashmi K. Sharma, MD, MHS, of Northwestern University in Evanston, Illinois, observed 6,288 patients with metastatic cancer who were hospitalized from January 2009 to December 2010 at an urban academic medical center. They used patient-level multivariable logistic regression to evaluate the association between race/ethnicity and inpatient palliative care consultation.
The researchers found that 16% of white patients, 22% of African-American patients, and 20% of Hispanic patients had an inpatient palliative care consultation.
Compared to white patients, African-American patients were found to have a greater likelihood of receiving an inpatient palliative care consultation, even upon adjustment for insurance, hospitalization, marital status, and illness severity.
RELATED: ASCO Updates Metastatic Lung Cancer Therapy Guideline to Include Targeted Agents, Early Palliative Care
In those patients who received consultation, African-Americans had a higher median number of days from consultation to death compared to white patients. They were also more likely than Hispanics, but not whites, to be referred to hospice.
“Additional research is needed to identify interventions to improve access to palliative care in the hospital for all patients with advanced cancer,” the authors concluded.
- Sharma RK, Cameron KA, Chmiel JS, et al. Racial/Ethnic Differences in Inpatient Palliative Care Consultation for Patients With Advanced Cancer. Journal of Clinical Oncology. [online ahead of print]. 2015. doi: 10.1200/JCO.2015.61.6458.