Racial Differences in Burdensome Transitions in Heart Failure Patients with Palliative Care: A Propensity-Matched...

Area of Science:

• Health Services Research
• Racial Disparities in Healthcare
• Palliative Care

Background:

• Racial disparities in heart failure (HF) treatment necessitate culturally competent clinical practices.
• Palliative care (PC) consultation is increasingly recognized for its role in managing complex chronic conditions.

Purpose of the Study:

• To compare the frequency of burdensome transitions between Black and White Veterans hospitalized with HF after receiving PC consultation.
• To identify potential racial disparities in healthcare experiences following PC consultation in HF patients.

Main Methods:

• A retrospective study of Veterans Administration (VA) hospital admissions for HF between October 2010 and August 2017.
• Propensity score matching was used to create comparable groups of Black and White Veterans based on demographic, comorbidity, clinical, and survival data.
• The cohort included 1592 well-matched Veterans (796 Black, 796 White) with a standardized mean difference <0.15 for all variables.

Main Results:

• Matched Black Veterans experienced significantly more burdensome transitions compared to White Veterans within the six-month follow-up period (27.4% vs. 21.9%, p=0.011).
• The analysis identified a statistically significant difference in the rate of burdensome transitions between racial groups.

Conclusions:

• Racial disparities persist in the experience of burdensome transitions among hospitalized heart failure patients even after palliative care consultation.
• These findings underscore the need for targeted interventions to address systemic inequities in HF care for minority Veterans.