As noted by panelists yesterday, in addition to higher rates of hospitalizations, ED visits, ICU stays and feeding tube insertions and lower rates of hospice use at the end of life, racial and ethnic minorities experience lower quality pain management. They also report lower quality communication with providers, are less likely to receive care consistent with preferences, and report lower overall satisfaction with end-of-life care. Research in the last year provides evidence that African Americans who enroll in hospice may receive care that is of lower quality than whites (i.e. fewer visits from professional stay in the last days of life; Teno et al. JAMA Intern Med. 2016;176(3):364-370).
As we think about potential strategies to reduce these disparities, what are the most important causes and most promising targets for intervention?
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