FACTORS INFLUENCING ETHNIC/RACIAL DISPARITY IN HOSPICE CARE
Ethnic and racial differences in the quality and access to health care are recognized for some minority groups. However, studies on disparities in hospice care are inadequate compared to other sections of health care like early detection, disease prevention, and curative care. Considering the highly growing older population of the minority groups, the accessibility of high-quality palliative care that satisfies the varying needs of older people of all ethnicities and races should be the priority. Most of these older adults face severe advanced sickness. The essay below reviews the factors that have the most impact on the limited or no opportunity to access to hospice care by the ethnic and racial minority groups. It will focus on the extent and ways in which these factors affect the palliative care provision. Moreover, the extent to and the vantage from which bias or systematic discrimination plays a role in disparity in hospice care will be discussed.
In hospice care, disparities exist in the receipt of suitable communication between physicians and patients. Even though all patients are in a similar setting, Medical doctors seem to offer less support and convey less information to Hispanic and African American patients compared to white patients. Also, minority patients do not always acquire treatment that meets their expectations, even when their needs are recognized. The significant factors that contribute to this include the cultural, ethnic, and religious beliefs of the healthcare providers (Narayan,2010). The factors affect the decisions of health care providers to take part in making decisions concerning palliative care and to explain hospice care to patients. In situations where the ethnic, religious, and cultural beliefs of the patients and the health care providers differ, the probability of the providers to offer hospice care is low. Medical practitioners have to consider the religious, cultural, and ethnic beliefs of the patients and their families before giving a poor prognosis (Narayan,2010). The decisions also affect the decisions made by the patients, and therefore they must be considered before evaluating and treating pain and offering palliative care.
Moreover, systematic discrimination plays a role in the difference in hospice care. Patients from minority groups in the U.S do not have the same access to pain care. The problem extends to all health care settings, including outpatient clinics, emergency rooms, nursing homes, and inpatient services. The disparity is always associated with system-related factors like insufficient health insurance and limited access to specialty care (Bullock, 2011). For this reason, unlike the non-Hispanic white patients, the ethnic/racial minority patients rarely report the scarcity of pain specialists. Even though all the patients are in the same socioeconomic status, the minority patients continue to face the risk of disparities in hospice care. The inadequacy of analgesic medications is a possible obstacle to the management of pain. The opioid stocks in pharmacies in the minority neighborhoods are inadequate. Also, in the struggle to curb the rising rates of substance abuse and change, more restrictions are being developed at the federal and state level (Bullock, 2011). The limits focus on the prescription practices of medical practitioners. The minority populations form the majority of patients who sign up for state Medicaid programs. Most of these programs have established strict conditions for coverage and authorization of opioids. The regulations result in reduced prescribing practices, which lead to increased access and disparity to these significant medications.
References
Bullock, K. (2011). The influence of culture on end-of-life decision making. Journal of social work in end-of-life & palliative care, 7(1), 83-98.
Narayan, M. C. (2010). Culture’s effects on pain assessment and management. AJN The American Journal of Nursing, 110(4), 38-47.