Racial Differences in End-of-Life Care: Hospitalization and Expenditures

A growing body of evidence shows consistent racial differences in the intensity of end-of-life (EOL) medical care in the U.S. (NEJM JW Gen Med Aug 1 2016 and J Clin Oncol 2016; 34:2265; Cancer 2016; 122:1905; and NEJM JW Gen Med Sep 15 2016 and JAMA 2016; 316:769). Two new studies provide additional insights.

Using several Medicare-related databases, researchers examined EOL hospitalization among nearly 400,000 nursing home residents. Black residents had a significantly higher rate of hospitalization during the last 30 days of life than did white residents (43% vs. 32%); among a subgroup of patients with severe cognitive impairment, the difference was even more striking (37% vs. 22%). White residents were much more likely than black resident…