Sex and Racial/Ethnic Differences in End-of-Life Care in Texan Medicare Colorectal Cancer Decedents.
Myrna Katalina Serna, Bethany Leach, Efstathia Polychronopoulou and 3 others
PMID 40411188WHAT IT FOUND
In the last 30 days of life, female colorectal cancer decedents used hospice more and ICU care less than males.
Non-Hispanic Black decedents had more emergency, ICU, and inpatient care and less hospice. Billed advance care planning was rare.
Key findings
01Female decedents were more often enrolled in hospice (73% vs 66%) and had more hospice days (mean 13.6 vs 11.6 days), while male decedents were more often admitted to the ICU (21% vs 18%).
02Non-Hispanic Black decedents had more emergency visits (50% vs 41%), ICU admissions (24% vs 19%), and inpatient admissions (54% vs 44%), but less hospice enrollment (62% vs 71%) than non-Hispanic White decedents.
03Billed advance care planning was rare overall, with only 1.7% to 2.2% of decedents having a billed encounter in the last 30 days, and no significant difference between groups.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study only looked at people aged 66 or older who died from colorectal cancer in Texas, so it does not describe younger patients or other states. It only reported non-Hispanic White, non-Hispanic Black, and Hispanic groups, not more detailed racial or ethnic categories. It used Medicare claims for services billed in the last 30 days, not patient or family preferences or notes. It used the education and poverty rates of the zip code where each person lived as a stand-in for that person's socioeconomic status. It did not measure whether palliative care consultations happened earlier in the life course.
Declared interests
The authors declared no potential conflicts of interest.
The easy way to misread this
Do not read these differences as proof that sex or race/ethnicity caused the care received. The study observed Medicare claims after death, did not measure patient or family preferences, and did not test any treatment.