Racial, Ethnic, and Socioeconomic Differences in Critical Care Near the End of Life: A Narrative Review

Crit Care Clin. 2024 Oct;40(4):753-766. doi: 10.1016/j.ccc.2024.05.007. Epub 2024 Jun 12.

Abstract

Patients from groups that are racially/ethnically minoritized or of low socioeconomic status receive more intensive care near the end of life, endorse preferences for more life-sustaining treatments, experience lower quality communication from clinicians, and report worse quality of dying than other patients. There are many contributory factors, including system (eg, lack of intensive outpatient symptom management resources), clinician (eg, low-quality serious illness communication), and patient (eg, cultural norms) factors. System and clinician factors contribute to disparities and ought to be remedied, while patient factors simply reflect differences in care and may not be appropriate targets for intervention.

Keywords: End of life; Intensive care units; Racial groups; Socioeconomic factors.

Publication types

  • Review

MeSH terms

  • Critical Care*
  • Ethnicity*
  • Healthcare Disparities* / ethnology
  • Humans
  • Racial Groups
  • Socioeconomic Factors*
  • Terminal Care*