Symptom Burden Is Lower in Asian and Pacific Islander and Black Men Admitted to Home-Based Palliative Care in an Integrated Health Care System.

Abstract

<b><i>Background:</i></b> Little is known about racial/ethnic differences in symptom severity among patients receiving home-based palliative care (HomePal). <b><i>Objectives:</i></b> To determine whether symptom severity differs between White patients and patients of color receiving HomePal and whether gender moderates the difference. <b><i>Design:</i></b> This is a cross-sectional exploratory study. <b><i>Setting/Subjects:</i></b> Baseline data were from 2090 patients receiving HomePal in Kaiser Permanente Southern California. <b><i>Measurements:</i></b> Multivariable median regression analyses were carried out across race/ethnicity groups and stratified by gender to assess differences in Edmonton Symptom Assessment System (ESAS) scores at HomePal admission. <b><i>Results:</i></b> Asian/Pacific Islander men and Black men had lower ESAS scores compared than White men (-5 [-7.8, -2.2], <i>p</i> = 0.0005 and -5.4 [-8.7, -2.1], <i>p</i> = 0.001, respectively); there were marginal ESAS differences across race/ethnic groups for women. <b><i>Conclusion:</i></b> Patients of color reported lower symptom severity than White patients. More research is needed to understand how the intersection of culture and gender affects symptom experience and reporting in patients living with serious illness. Trial Registration: ClinicalTrials.gov: NCT#03694431.