Palliative care is end-of-life care focused on making the very ill more comfortable in their final days. This type of care can prolong survival and improve a patient’s quality of life. It can also provide some relief to families struggling with seeing their loved one suffer.
So why are some populations less likely to receive that care than their counterparts? A new study from Brigham and Women’s Hospital in Boston sought to answer that question through retrospective analysis.
“We knew that black and Hispanic cancer patients receive palliative care at lower rates than white patients, but until now, we didn’t know why“ Alexander P. Cole from the division of urological surgery from Brigham and Women’s said of the study. When identifying the source of this disparity, a multitude of possible factors makes it difficult for researchers to pinpoint any one cause.
In the study, researchers found some hospitals providing palliative care at only two thirds the rate of other hospitals. Researchers also found that the hospitals lacking in providing care tend to disproportionately treat minorities. “We find that the site of care seems to be a key determinant of whether or not someone receives palliative care” said co-author Quoc-Dien Trinh.
For the study, researchers conducted a registry-based analysis of adults diagnosed with four types of spreading, cancer. They pulled their data from the participant use files of the National Cancer Database (NCBD.) Patients were men and women over 40 years old with prostate, lung, colon and breast cancers. Researchers measured how often patients received palliative care such as pain management, surgical treatment, and radiation therapy.
Then researchers defined hospitals as minority-serving or non-minority serving. This revealed that 21.7% of patients with metastatic cancer received palliative care. Of those, 22.5% were white, 20% were black, and only 15.9% were Hispanic. After making adjustments for variables, the team concluded that minority-serving hospitals were only two thirds as likely as non-minority serving hospitals to provide palliative care to patients, regardless of the patient’s race or ethnicity.
It is the mission of public health professionals to identify, study, and develop strategies to reduce these types of disparities. Not only do these disparities add to the cost of healthcare in the US overall, but they also make broad gains in healthcare challenging to implement.
Although the research for this article focused on palliative care for patients with late-stage cancer, there are a number of illnesses for which this type of care might be offered. These illnesses include heart disease, lung disease, kidney failure, dementia, AIDS and more.
The services involved are often provided by a team of doctors, nurses, dietitians, psychologists, and even massage therapists. Palliative care can start as soon as diagnosis and be provided throughout treatment.
Palliative care differs from hospice because hospice is reserved for those with less than six months to live or those who are extremely unlikely to survive further treatment while those in palliative care may improve or recover.
If you’re seeking palliative care for yourself or a loved one, know that it is most often covered by health insurance. Don’t be afraid to ask your provider about this comforting option.