Studies Show Differences in Quality of Palliative Care

Black patients and patients with organ failure report poor levels of palliative care
A black patient receives a shot in a hospital as part of palliative care

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Palliative care is designed to provide comfort to people who have terminal illnesses. Yet multiple studies show that not all patients receive the same quality of care. In one study of Veterans Administration hospitals, black patients were less likely than white patients to receive basic services such as chaplain consults. What’s more, many black patients said that they received less than excellent care. By contrast, white patients were more likely to report excellent care.

According to the study, both black and Latino patients reported receiving less palliative services than their white peers. Furthermore, separate studies have shown that black and Latino patients consistently receive sub-par medical care. Researchers have found that ethnic minorities who visit emergency rooms are less likely to receive pain-reducing drugs, even when they present with conditions such as broken bones. Other studies have shown that kidney transplant rates are lower among blacks than whites.

Even doctors aren’t immune to racial discrimination in hospitals. Dr. Ron

A bottle of pain-reducing pills, often given to palliative care patients

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Wyatt (who is black) went to the hospital after measuring his own temperature at 104 degrees. Not only did he receive substandard care from nurses and doctors, his doctors were reluctant to give him information about his test results. At one point, a nurse didn’t believe him when he told her what his name was and demanded to see his ID. Wyatt believes he experienced what many ethnic minorities in this country deal with every day.

To address these issues, researchers suggest strategies aimed at eliminating the unconscious bias that many staff members display. They recommend more oversight and thorough training to help staff members deal with subtle racial prejudices that they may not be aware of.  The goal is to provide every patient the same level of care and remedy the racial disparities that exist.

Diagnosis Effects Palliative Care

In addition to inequities based on race, the study also found that patients were less likely to receive excellent palliative care if they suffered from organ failure, frailty or heart disease. On the whole, cancer and dementia patients tended to receive better care.  This tells researchers that cancer patients and people who have dementia consume the most end-of-life resources, even though heart disease is the leading cause of death in the United States.

Healthcare worker taking a patients blood pressure to assess palliative care needs

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Researchers still aren’t sure why organ failure patients receive such poor palliative care. One theory is that staff receive better training in palliative care for patients with cancer and dementia. Training in other areas may fall short. Another theory is that these illnesses require different levels of palliative care over varying periods of time.

For example, a cancer patient might need more support during chemotherapy treatments and less during times of remission. Conversely, a patient suffering from organ failure might need long-term, around-the-clock care. A more patient-focused healthcare plan might alleviate some of these problems. So would better communication between patients and hospital staff.

Doctors and scientists are continuing to study disparities in patient care. Thus, we might see our palliative care system transform over the next few years. At the moment, families make up for the shortcomings in our healthcare system, which takes a huge emotional and physical toll. Hopefully, healthcare reform will help more patients get the comfort care they need.

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