The High End Cost of Cancer
Blacks and Hispanics spend more on end-of-life care than whites
Throughout most of their lives,
blacks and Hispanics spend less
on medical services than whites.
But at the end of life, the trend is
reversed—there is a sudden burst
of spending during the last six
months of care among racial and
ethnic minorities. So says a study
in the March 9 Archives of Internal
Medicine, which suggests that
much of the cost is tied to life-sustaining interventions.
The first study looked at
Medicare expenditures in the last
six months of life among nearly
159,000 people who had died. For
all causes of death, the cost for
whites averaged about $20,200;
whereas the average cost for blacks
and Hispanics was about $26,700
(32 percent more) and $31,700
A second report in the same
issue of the journal offers further
insight into the disparity: End-of-life conversations between
physicians and patients with
advanced cancer correlate with
the costs of health care in the last
week of life.
(57 percent more), respectively.
When the cause of death was
cancer, the cost of end-of-life care
for blacks and Hispanics was
“Even after adjusting for
location, we see that roughly
half of the difference in cost is
associated with using aggressive
intervention at the end of life,”
says health services researcher
Amresh Hanchate of the Boston
University School of Medicine,
who worked on the study.
Admission to intensive care units,
resuscitation and mechanical
ventilation were more common
among minorities than whites.
16 percent more and 36 percent more,
respectively, than it was for whites.
Hanchate cautions that the
study looked only at patients who
died, making it difficult to know if
others benefited from the same
procedures. Nor did the research
reveal why these differences among
racial and ethnic groups exist.
CR | Page No. 10 | Summer 2009
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Health care services—including
end-of-life care—tend to be more
expensive in urban areas. And
because minorities are more
likely than whites to be urban
dwellers, researchers thought
this geographic difference might
explain the increase in end-of-life
costs. However, it turns out that’s
not the whole picture.
In the second study, researchers
found that medical costs were
36 percent lower among patients
who discussed end-of-life issues
with their physicians compared with
PODCAST
End-of-Life Care
Fifty percent of patients
with metastatic lung cancer
don’t discuss hospice with
their doctors.
Click here to listen
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pgs 10-11 cost of cancer texterity.indd 10
7/15/09 2:09:35 PM
