A study published in JAMA suggests that Black people are less likely to receive hospice care and more likely to receive intensive treatment in the last six months of life, regardless of cause of death, compared to White people.
Researchers examined 1,212 fee-for-service Medicare beneficiaries who died of natural causes between 2013 and 2015. Overall, Blacks were more likely to have multiple emergency department visits and hospitalizations, and receive intensive interventions in the last six months of life. During those last six months, Blacks were less likely to use at least three days of hospice care. High intensive treatment at end-of-life does not always improve survival and may increase suffering.
Cause of death also influenced hospice care and treatment intensity. Compared with people who died from cancer, those who died of cardiovascular causes were more likely to have multiple hospital stays, emergency department visits and procedures such as intubation and ventilation.
The fact that racial disparities in end-of-life care improved for cancer patients demonstrates that there is more that can be done to close these gaps in other fields of medicine such as cardiology, nephrology and neurology.