Trends and Racial Disparities of Palliative Care Use among Hospitalized Patients with ESKD on Dialysis.

Link: https://doi.org/10.1681/ASN.2018121256
Authors: Wen, Yumeng; Jiang, Changchuan; Koncicki, Holly M; Horowitz, Carol R; Cooper, Richard S; Saha, Aparna; Coca, Steven G; Nadkarni, Girish N; Chan, Lili

Abstract: Study findings show that although palliative care decreases symptom burden, it is still underused in patients with ESKD. Little is known about disparity in use of palliative care services in such patients in the inpatient setting. To investigate the use of palliative care consultation in patients with ESKD in the inpatient setting, we conducted a retrospective cohort study using the National Inpatient Sample from 2006 to 2014 to identify admitted patients with ESKD requiring maintenance dialysis. We compared palliative care use among minority groups (black, Hispanic, and Asian) and white patients, adjusting for patient and hospital variables. Despite a clear increase during the study period in provision of palliative care for inpatients with ESKD, significant racial disparities occurred and persisted across all hospital subtypes. Further investigation into causes of racial and ethnic disparities is necessary to improve access to palliative care services for the vulnerable ESKD population.