ArticleJournal of general internal medicine2022
Advance Care Planning and Treatment Intensity Before Death Among Black, Hispanic, and White Patients Hospitalized with COVID-19.
Article in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 17 citations in OpenAlex.
- Anticipatory Advance Care Planning Visits and COVID-19 Treatment Intensity Among Medicare Fee-for-Service Beneficiaries: A Retrospective Observational Study.Journal of general internal medicine · 2026Observational
- Disparities in Advance Care Planning: Did COVID-19 Change Anything?Journal of the American Geriatrics Society · 2026Article
- Race and Ethnicity and Early Do Not Attempt Resuscitation Orders After In-Hospital Cardiac Arrest.JAMA network open · 2026Article
- Palliative care impact on hospital utilization and trends among lung cancer admissions with a high risk of mortality in U.S. hospitals.Frontiers in health services · 2026Article
- A Research Agenda to Mitigate Racial and Ethnic Disparities in U.S. Critical Care Medicine: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2025Article
- Family satisfaction with the end-of-life discussions and resuscitation orders for patients with severe COVID-19: a multicenter study in Saudi Arabia.BMC medical ethics · 2025Article
- Racial, Ethnic, and Socioeconomic Differences in Critical Care Near the End of Life: A Narrative Review.Critical care clinics · 2024Review
- Impact of the COVID-19 Public Health Crisis and a Structured COVID Unit on Physician Behaviors in Code Status Ordering.The American journal of hospice & palliative care · 2024Article
- Racial Differences in Treatment Intensity at the End of Life Among Older Adults with Heart Failure: Evidence from the Health and Retirement Study.Journal of palliative medicine · 2024Article
- Racial differences in low value care among older adult Medicare patients in US health systems: retrospective cohort study.BMJ (Clinical research ed.) · 2023Article
- Survey of Advance Care Planning Practices in Elderly COVID-19 Patients: A Multicenter Questionnaire Survey.Cureus · 2023Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundBlack and Hispanic people are more likely to contract COVID-19, require hospitalization, and die than White people due to differences in exposures, comorbidity risk, and healthcare access.
objectiveTo examine the association of race and ethnicity with treatment decisions and intensity for patients hospitalized for COVID-19.
designRetrospective cohort analysis of manually abstracted electronic medical records. PATIENTS: 7,997 patients (62% non-Hispanic White, 16% non-Black Hispanic, and 23% Black) hospitalized for COVID-19 at 135 community hospitals between March and June 2020 MAIN MEASURES: Advance care planning (ACP), do not resuscitate (DNR) orders, intensive care unit (ICU) admission, mechanical ventilation (MV), and in-hospital mortality. Among decedents, we classified the mode of death based on treatment intensity and code status as treatment limitation (no MV/DNR), treatment withdrawal (MV/DNR), maximal life support (MV/no DNR), or other (no MV/no DNR). KEY
resultsAdjusted in-hospital mortality was similar between White (8%) and Black patients (9%, OR=1.1, 95% CI=0.9-1.4, p=0.254), and lower among Hispanic patients (6%, OR=0.7, 95% CI=0.6-1.0, p=0.032). Black and Hispanic patients were significantly more likely to be treated in the ICU (White 23%, Hispanic 27%, Black 28%) and to receive mechanical ventilation (White 12%, Hispanic 17%, Black 16%). The groups had similar rates of ACP (White 12%, Hispanic 12%, Black 11%), but Black and Hispanic patients were less likely to have a DNR order (White 13%, Hispanic 8%, Black 7%). Among decedents, there were significant differences in mode of death by race/ethnicity (treatment limitation: White 39%, Hispanic 17% (p=0.001), Black 18% (p<0.0001); treatment withdrawal: White 26%, Hispanic 43% (p=0.002), Black 28% (p=0.542); and maximal life support: White 21%, Hispanic 26% (p=0.308), Black 36% (p<0.0001)).
conclusionsHospitalized Black and Hispanic COVID-19 patients received greater treatment intensity than White patients. This may have simultaneously mitigated disparities in in-hospital mortality while increasing burdensome treatment near death.
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