Investigating Racial Differences in End-of-Life Care Quality

Background of the Study

Researchers have explored whether racial disparities exist in the quality of end-of-life care provided in hospitals, hospices, or at home. Numerous studies conducted in the United States indicate that variations in care quality across different races may affect several aspects of end-of-life care, such as symptom management, communication, and clinical outcomes.

Efforts to Improve Care Quality

In response to these findings, hospital management teams have implemented various measures aimed at enhancing care quality for patients and addressing racial disparities. Researcher RK Sharma and her team examined whether these new strategies have effectively reduced racial differences in end-of-life care quality. Their findings were published in the 2017 edition of JAMA Internal Medicine.

Study Methodology

To conduct their assessment, Sharma and her team analyzed survey data from the National Health and Aging Trends Study (NHATS). This study monitored the care received by patients at hospitals, hospices, or home settings from 2011 to 2015, involving 1,106 participants aged 65 and older. Race information was documented and utilized in the study with participant consent.

After completing the questionnaire, patients’ relatives were also given a survey to evaluate their perceptions of the end-of-life care provided. This questionnaire assessed various aspects, including health professionals’ management of symptoms and pain, decision-making efficiency, emotional support from healthcare providers, and an overall quality rating of the hospital or hospice.

Findings of the Study

The results revealed that the overall quality of end-of-life care was comparable for both white and black patients. However, families of white patients were more likely to report issues such as a lack of respect in treatment, care decisions not aligning with patient wishes, and insufficient family involvement in care decisions.

Both black and white respondents generally deemed end-of-life care adequate, but fewer than half rated it as excellent. These findings suggest that the overall perception of end-of-life care was not exceptional across both racial groups, indicating a need for substantial improvements to benefit all patients in the United States.

Impact of Hospital Changes

Despite these concerns, the study indicated that significant changes implemented by hospitals in the U.S. appeared to positively influence the reduction of racial disparities in the quality of end-of-life care. The results of this research highlight the potential benefits of management changes aimed at decreasing racial differences in care quality.

Reference

Sharma, R. K., Freedman, V. A., Mor, V., Kasper, J. D., Gozalo, P., & Teno, J. M. Association of Racial Differences With End-of-Life Care Quality in the United States. JAMA Internal Medicine.