Sex and Racial/Ethnic Differences in End-of-Life Care in Texan Medicare Colorectal Cancer Decedents

Strategic Insights -

A recent study published in the American Journal of Hospice and Palliative Medicine has shed light on the disparities in end-of-life care for colorectal cancer patients in Texas. The research, conducted by a team of investigators from the University of Texas Medical Branch, analyzed data from 5,757 Medicare patients who died from colorectal cancer between 2010 and 2018. The study found that female decedents were more likely to be hospice-enrolled, while non-Hispanic Black and Hispanic decedents had higher healthcare utilization and lower hospice enrollment compared to non-Hispanic White decedents.

Key Takeaways:

  • The study found sex and racial/ethnic differences in end-of-life health care utilization, advance care planning, and associated outcomes among Texan Medicare colorectal cancer decedents.
  • Female decedents were significantly more likely to be hospice-enrolled, with 14.1% of female decedents enrolling in hospice care compared to 10.5% of male decedents.
  • Non-Hispanic Black decedents had greater healthcare utilization, including inpatient stays, and lower hospice enrollment compared to non-Hispanic White decedents.
  • Hispanic decedents had lower hospice enrollment and higher healthcare utilization compared to non-Hispanic White decedents.
  • The study highlighted the need for more work to incorporate advance care planning and billing into regular workflows.
  • The research team used chi-square tests, t-tests, or ANOVA as appropriate for outcomes in the last 30 days of life to assess sex and racial/ethnic differences.
  • Multivariable logistic regression models were used to assess differences in the odds of inpatient admission and hospice enrollment.

Statistics:

  • The study analyzed data from 5757 Medicare patients who died from colorectal cancer between 2010-2018.
  • 14.1% of female decedents enrolled in hospice care compared to 10.5% of male decedents.
  • Non-Hispanic Black decedents had a 21.1% higher risk of inpatient admission compared to non-Hispanic White decedents.
  • Hispanic decedents had a 12.5% lower risk of hospice enrollment compared to non-Hispanic White decedents.

Sources:

  • American Journal of Hospice and Palliative Medicine, 2025, "Sex and Racial/ethnic Differences In End-of-life Care In Texan Medicare Colorectal Cancer Decedents."
  • University of Texas Medical Branch, "Study Results from University of Texas Medical Branch Broaden Understanding of Colon Cancer (Sex and Racial/ethnic Differences In End-of-life Care In Texan Medicare Colorectal Cancer Decedents)."
  • Cancer Weekly, June 17, 2025, p 82.