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

Abstract

<b><i>Background:</i></b> 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. <b><i>Objective:</i></b> To compare burdensome transitions for Black and White Veterans hospitalized with HF after PC consultation. <b><i>Participants:</i></b> This retrospective study evaluated Veterans admitted for HF to Veterans Administration hospitals who received PC consultation from October 2010 through August 2017. <b><i>Methods:</i></b> We propensity-matched Black to White Veterans using demographic, comorbidity, clinical, hospital, and survival time data. <b><i>Results:</i></b> Propensity matching of our cohort (<i>n</i> = 5638) yielded 796 Black and White Veterans (total <i>n</i> = 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 (<i>n</i> = 218, 27.4% vs. <i>n</i> = 174, 21.9%; <i>p</i> = 0.011) over the six-month follow-up period. <b><i>Conclusions:</i></b> This propensity-matched cohort found racial differences in burdensome transitions among admitted HF patients after PC consultation.