Black, Hispanic patients with lymphoma less likely to receive palliative care
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Key takeaways:
- Black, Hispanic patients with lymphoma are significantly less likely to receive palliative care than white patients.
- Palliative care associated with less hospitalization cost but had no significant impact on length of stay.
SAN DIEGO — Patients with lymphoma who receive palliative care incur significantly lower total hospitalization charges than patients who do not, according to study findings presented at ASH Annual Meeting and Exposition.
Researchers also noted racial and ethnic disparities in access to palliative care, with Black and Hispanic patients appearing to have significantly lower odds of receiving such care than their white counterparts.
“We conducted this study and analysis with the aim of addressing existing biases in modern medicine, especially in providing adequate care for [patients with] lymphoma. These biases manifest in institutional, financial, geographical, and racial aspects,” Chieh Yang, MD, a resident physician of internal medicine at University of California, Riverside, told Healio.
“Our focus was on investigating and uncovering insights into these biases in the utilization of palliative care among [patients with] lymphoma, which motivated the undertaking of this study,” she added. “The key message to take away is the need to tackle these disparities and prevent biases in clinical practice for [patients with] lymphoma.”
Background and methodology
Researchers conducted a retrospective study using hospitalization data from the National Inpatient Sample from January 2016 to December 2019 to study the characteristics and utilization patterns of palliative care among patients with lymphoma. The analysis evaluated the impact of palliative care on healthcare utilization — specifically, discounted hospital charges and length of stay.
The investigators conducted multivariate linear and logistic regression analysis stratified by age, race, Charlson comorbidity index, insurance status, median household income and hospital characteristics.
The final analysis included 10,323 deceased patients with lymphoma, of which 5,464 individuals (52.9%) received palliative care during their respective hospital stays.
Results, next steps
According to multivariate linear regression analysis, patients with lymphoma who received palliative care had significantly lower total charges (mean decrease = $24,269; 95% CI, $37,263 - $11,277) when compared with similar patients who did not receive such care.
Patients that identified as Black (OR = 0.78; 95% CI, 0.67 – 0.91) or Hispanic (OR = 0.83; 95% CI, 0.71 – 0.97) had lower odds of receiving palliative care, while patients with Medicare had the lowest probability of receiving palliative care when compared with other insurance groups, such as Medicaid (OR = 1.34; 95% CI, 1.12 – 1.62) or private insurance (OR = 1.57; 95% CI, 1,40 – 1.76).
However, researchers did not report a statistically significant difference in length of hospital stay between the two patient groups (coefficient = –0.07 days; 95% CI, –0.69 to 0.54).
According to researchers, such findings underscore a need to address racial and ethnic disparities in access to palliative care to ensure equitable provision of care for all patients with lymphoma.
Study limitations included lack of consideration for survival time as a potential stratification factor, in addition to evaluating data on deceased patients.
Future studies could further break down patient data to further analyze the impact of palliative care more thoroughly, researchers noted.
“Our study was retrospective, highlighting the necessity for prospective research. We exclusively focused on patients who passed away in the hospital,” Yang told Healio. “Conducting a study involving living patients, preferably in an outpatient setting with a prospective design, can provide further insights, answer additional questions, and allow for a comparison of findings with our study.”
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Patel R, et al. Abstract 131. Presented at: ASH Annual Meeting and Exhibition; Dec. 9-12, 2023; San Diego.
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