Access to palliative care varies significantly among patients of different ethnic or racial backgrounds, genders or socioeconomic status.
This is according to a recent study in the journal Cureus. White patients were considerably more likely to receive palliative care than people of color. Men were more likely to get palliative care than women, and disparities were also observed between higher and lower income brackets and among the insured and uninsured.
“Addressing cultural barriers, increasing cultural competency among health care providers, and enhancing outreach efforts within underserved communities are essential steps to promote equitable access to palliative care across diverse populations,” the study authors wrote. “Health care financing mechanisms play a critical role in shaping access to palliative care services and the need for policy interventions to ensure adequate reimbursement for palliative care delivery.”
During the six-year study, researchers examined records for 5.24 million patients from 45 states who received palliative care during a hospital admission, as well as a similar number of patients who did not. The study used data from the National Inpatient Sample provided by the Healthcare Cost and Utilization Project (HCUP).
The study also found that the uninsured were less likely to receive palliative care. Patients who were covered under private insurance received palliative care more often than those in Medicare or Medicaid. Disparities also existed for rural patients, who often do not get palliative care due to lack of availability.
Multiple studies have confirmed the benefits of palliative care, according to the research. These include increased patient and provider satisfaction, equal or better symptom control, more discernment of and honoring choices about the place of death, fewer and fewer intensive hospital admissions in the last month of life, less anxiety and depression, less caregiver distress and cost savings.
A range of interventions must be implemented to fully address this problem, including some at the health care system level, the study authors concluded.
“Targeted investments in palliative care infrastructure, workforce development and community-based programs are essential to expand access to palliative care services in underserved areas,” they wrote. “Additionally, reallocating resources toward preventive care, early screening and chronic disease management can help reduce the need for PC interventions among disadvantaged populations.”