Race as a Predictor of Palliative Care Referral Time,Hospice Utilization,and Hospital Length of Stay: A Retrospective Noncomparative Analysis

Abstract

Background:

Palliative care is associated with significant benefits, including reduced pain and suffering, an increased likelihood of patients dying in their preferred location, and decreased health-care expenditures. Racial and ethnic disparities are well-documented in hospice use and referral patterns; however, it is unclear whether these disparities apply to inpatient palliative care services.

Objective:

To determine if race is a significant predictor of time to inpatient palliative care consult, patient enrollment in hospice, and patients’ overall hospital length of stay among patients of an inpatient palliative care service.

Design:

Retrospective noncomparative analysis.

Setting:

Urban academic medical center in the United States.

Patients:

3207 patients referred to an inpatient palliative care service between March 2006 and April 2015.

Measurements:

Time to palliative care consult, disposition of hospice/not hospice (excluding patients who died), and hospital length of stay among patients by racial (Asian, black, Native American/Eskimo, Hispanic, white, Unknown) and ethnic (Hispanic/Latino, non-Hispanic, Unknown) background.

Results:

Race was not a significant predictor of time to inpatient palliative care consult, discharge to hospice, or hospital length of stay. Similarly, black/white, Hispanic/white, and Asian/white variables were not significant predictors of hospice enrollment (Ps > .05).

Limitations:

Study was conducted at 1 urban academic medical center, limiting generalizability; hospital race and ethnicity categorizations may also limit interpretation of results.

Conclusions:

In this urban hospital, race was not a predictor of time to inpatient palliative care service consult, discharge to hospice, or hospital length of stay. Confirmatory studies of inpatient palliative care services in other institutions are needed.

Keywords

disparities inpatient palliative care palliative care hospice care race and ethnicity urban palliative care consult

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