Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Center of Innovation in Long Term Services and Supports, Providence Veteran Affairs Medical Center, Providence, Rhode Island, USA.
J Palliat Med. 2022 Jul;25(7):1122-1126. doi: 10.1089/jpm.2021.0317. Epub 2022 Mar 11.
Examining racial disparities in the treatment of heart failure (HF) patients and the effects of palliative care (PC) consultation is important to developing culturally competent clinical behaviors. To compare burdensome transitions for Black and White Veterans hospitalized with HF after PC consultation. This retrospective study evaluated Veterans admitted for HF to Veterans Administration hospitals who received PC consultation from October 2010 through August 2017. We propensity-matched Black to White Veterans using demographic, comorbidity, clinical, hospital, and survival time data. Propensity matching of our cohort ( = 5638) yielded 796 Black and White Veterans (total = 1592) who were well-matched on observed variables (standard mean difference <0.15 for all variables). Matched Black Veterans had more burdensome transitions than White Veterans ( = 218, 27.4% vs. = 174, 21.9%; = 0.011) over the six-month follow-up period. This propensity-matched cohort found racial differences in burdensome transitions among admitted HF patients after PC consultation.
研究心力衰竭 (HF) 患者治疗中的种族差异以及姑息治疗 (PC) 咨询的影响对于培养文化适应性的临床行为非常重要。本回顾性研究评估了 2010 年 10 月至 2017 年 8 月期间接受 PC 咨询后因 HF 住院的退伍军人的负担过重的转变。我们使用人口统计学、合并症、临床、医院和生存时间数据,对黑人退伍军人和白人退伍军人进行倾向评分匹配。我们队列的倾向评分匹配(n=5638)产生了 796 名黑人和白人退伍军人(总计 1592 名),观察变量匹配良好(所有变量的标准均差 <0.15)。在六个月的随访期间,匹配的黑人退伍军人的负担过重的转变比例高于白人退伍军人(n=218,27.4% vs. n=174,21.9%;=0.011)。这项倾向评分匹配的队列研究发现,在接受 PC 咨询后,因 HF 住院的患者在负担过重的转变方面存在种族差异。