This analysis uses current national-population-based data to elucidate trends in racial minority access to and utilization of palliative care services (PCS). 

This analysis utilized pooled data from the 2016-2019 United States Government Agency for Healthcare Research and Quality National Inpatient Sample (NIS), which contains >7 million unweighted hospital stays for each year. When weighted, it estimates >35 million hospitalizations yearly (95% of annual American hospitalizations). NIS’ International Classification of Diseases (ICD-10) codes were used for data extraction.

After weighting, 84,840 adult patients admitted with intracerebral hemorrhage were included. Patients with a hospital stay less than 24 hours were excluded, as patients likely passed away before being able to receive PCS counseling. T- and chi-square-tests compared groups.

16,940 (20%) of ICH patients received PCS. Patients who received PCS were significantly older (mean age 75 years, SD 13 vs. 68 years, SD 15, p<0.001) and were more likely to be female (57.2%, p<0.001) than patients who did not receive PCS. 

Caucasian ICH patients were significantly more likely to receive palliative care services (p<0.001). 23% of Caucasian ICH patients (n=11,940 of 52,125) received PCS. In comparison, only 12% of African American (n=1,740 of 13,835), 15% of Hispanic (n=1,285 of 8,690), and 19% of Asian/Pacific Islander (n=829 of 4,394) ICH patients received PCS. 

Intracerebral hemorrhage patients of racial minority status were disproportionately less likely to receive palliative care services. These findings emphasize the need for improvement in provider- and patient-education or modification of PCS resources to fit patients’ differing cultural needs to improve care accessibility.