Lack of Ethnic Differences in End-of-Life Care in the Veterans Health Administration.

Fischer, Stacy M.; Kutner, Jean S.; Sauaia, Angela; Kramer, Andrew

Although existing literature shows pervasive ethnic disparities in end-of-life care, this study sought to determine if there were ethnic differences in the processes of care related to the end of life in a cohort of hospitalized, seriously ill veterans. The medical records of 217 patients (13% African American, 68% white, 9% Hispanic White) were reviewed for documentation of end-of-life care (advance directive discussions, pain, symptom-directed plan, and do-not-resuscitate orders). Logistic regression modeling demonstrated no ethnic differences for the treatment of pain or a symptom-directed plan of care. African American patients were more likely to have a do-not-resuscitate order and advance directive discussion documented compared with white patients. In this equal access system, minority patients were at least as likely or more likely to have important aspects of end-of-life care addressed compared with white patients.

DISCRIMINATION in medical care; ETHNICITY; TERMINAL care; HEALTH equity; ADVANCE directives (Medical care)

American Journal of Hospice & Palliative Medicine, 2007, Vol 24, Issue 4, p277

1049-9091

Academic Journal

10.1177/1049909107302295