Financial and communication barriers are major impediments to quality end-of-life care for ethnic minorities.
Ethnic minorities want to have conversations with their physicians about quality end-of-life care, but barriers, such as poor communications and financial problems, interfere with that desire, according to Stanford University School of Medicine researchers. Their study in the Journal of Palliative Medicine found that ethnicity does not predict the type of end-of-life care people want.
“There is so much generalization and stereotyping by physicians about how ethnic minorities want ‘everything’ done, irrespective of how effective these treatments might be at the end of life,” lead author VJ Periyakoil, MD, clinical associate professor of Medicine at Stanford, said in a statement. “In reality, it is more of a socioeconomic issue than an ethnic issue.”
The inequalities in healthcare that occur across ethnic and socioeconomic groups persist well into end-of-life care, the study found, with seriously ill patients in ethnic minorities disproportionately affected by poor-quality care.
The researchers interviewed 315 people of multiethnic background (117 white Americans, 38 African-Americans, and 160 Asian Americans) older than 50 years from cities across the San Francisco Bay Area. Medical interpreters accompanied researchers into community-based senior centers, where interviews were conducted in participants’ preferred languages (Spanish and 5 Asian languages).
A majority (61%) of patients said there were barriers to receiving high-quality care for members of their ethnic group. The biggest barriers were finances and health insurance followed by physician behavior, communication problems with doctors, family beliefs, health system barriers, and cultural/religious barriers. There were no significant differences in how the various ethnic groups ranked the barriers.
Education level was found to have a significant effect on responses. Participants with no formal education found financial issues to be most challenging, followed by communication problems with physicians. Communication problems included doctors being too busy to initiate conversations and doctors being either unaware of or insensitive to cultural/spiritual needs, causing patients to avoid the intensely personal end-of-life conversations. In addition, participants had problems understanding medical terminology. Participants with any other level of education identified doctor behaviors as being the biggest barrier.
The study authors noted that providing culturally competent end-of-life care is becoming more essential in the United States as the nation becomes one with a majority population made up of minorities by 2033, and the fragmented healthcare system does a poor job of training doctors to communicate effectively with their patients about end-of-life choices.
Real-World Study Reveals Key Insights into DLBCL Treatment Patterns, Outcomes
April 18th 2024A recent study offers valuable insights into the characteristics, treatment patterns, and outcomes of diffuse large B-cell lymphoma (DLBCL) in patients across different lines of therapy, providing a look into the landscape of DLBCL management.
Read More
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
Collecting SDOH Data Can Assess Risk of Medical Nonadherence, Improve HEI and Star Ratings
April 18th 2024At the Academy of Managed Care Pharmacy (AMCP) 2024 annual meeting, a panel of presenters explored changes coming to Medicare that incorporate social determinants of health (SDOH) data to improve patient and health system outcomes.
Read More
Drs Raymond Thertulien, Joseph Mikhael on Racial Disparities in Multiple Myeloma Care Access
December 28th 2023In the wake of the 2023 American Society of Hematology Annual Meeting and Exposition, Raymond Thertulien, MD, PhD, of Novant Health, and Joseph Mikhael, MD, MEd, FRCPC, FACP, chief medical officer of the International Myeloma Foundation, discussed health equity research highlights from the meeting and drivers of racial disparities in multiple myeloma outcomes.
Listen
Commonwealth Fund Report Details Pervasive Racial and Ethnic Disparities in US Health Care, Outcomes
April 18th 2024Using 25 health system performance indicators, the Commonwealth Fund 2024 State Health Disparities Report evaluated racial and ethnic disparities in health care and health outcomes both within and across US states and highlighted the urgent need for equitable health care policies and practices in the US.
Read More