Nation’s Blacks, Hispanics have higher end-of-life costs

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Striking new research shows dying Blacks and Hispanics in the United States have much steeper treatment costs than whites, sobering evidence that racial healthcare differences continue right up until death.

Striking new research shows dying Blacks and Hispanics in the United States have much steeper treatment costs than whites, sobering evidence that racial healthcare differences continue right up until death.

It’s not that minorities are being charged more than whites. It’s that they tend to get more costly, intensive treatments including feeding tubes and other invasive medical procedures near death. That’s in sharp contrast with what often happens throughout their lives, when minorities are less likely than whites to get aggressive medical care.

The results raise a troubling question about whether medical resources for nonwhite patients are “misallocated over a lifetime,” with minorities receiving more treatment at the end, when there is little chance of improving or extending life, the study authors said.

The study appears in Monday’s Archives of Internal Medicine. It involved nearly 160,000 patients on Medicare government benefits for the elderly and records on their treatment in the last six months of life.

It is the most comprehensive on the topic and confirms results suggested in smaller studies on disparities in end-of-life care, said co-author Dr. Ezekiel Emanuel, a researcher in the bioethics department at the National Institutes of Health.

Medicare costs in those final months averaged $20,166 for whites. Among Blacks, they were $26,704, about 30 percent higher; and among Hispanics, $31,702 or almost 60 percent higher. Those individual cost differences can add up to billions of dollars on a national scale, Emanuel said.

Reasons why minorities receive more costly end-of-life care are unclear; the study had no data to explain that. But Emanuel and other doctors offered several theories.

“Some of it may be preference. Some of it may be fear-based,” Emanuel said.

Distrust of doctors and suspicions about getting less attentive treatment than whites likely is another factor, the study authors said.

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