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Democratizing Wound Care in Hospice Care Facilities

Hospice care facilities provide care for the terminally ill, including patients battling late-stage cancer, heart disease, and kidney failure, as well as those living with chronic non-healing wounds. In this article, The Wound Docs examines the effects of inequities in hospice care and proposes viable solutions to close the gap. 

Disparities in COVID-19 cases and mortalities in the U.S.

As the number of COVID-19 hospitalizations reaches record highs across the country, disease risk and mortality rates among minorities have reached unprecedented levels. Within U.S. states, the contrast is apparent. In Chicago, for example, over 50% of the reported cases and over 70% of fatalities are among African American populations. COVID-19 related mortality is six times higher in Black Americans than whites in Washington DC, five times higher in Missouri and Michigan, and three times higher in Louisiana, Illinois, and New York. 

Moreover, a report by a leading peer-reviewed journal has revealed that minority populations are underserved at hospice care facilities. The study used data from Medicare beneficiaries to collate numbers of admissions, hospice enrollment/dis-enrollment, and emergency department (ED) visits in whites and people of color. The researchers discovered several racial disparities in patterns of care between black and white enrollees. If these issues are left unaddressed, they may likely worsen over time. 

Inequities in hospice care and under-utilization by minorities

Social distancing and non-contact measures adopted across the country to slow the spread of the virus has adversely affected the amount of care many patients receive at long-term care facilities, particularly those without symptoms that are considered life-threatening. However, inequities in long-term facilities such as hospice homes are more pronounced among minorities such as African Americans, Native Americans, and Hispanic peoples. The problem has today come to the fore during the pandemic.

According to Sherita Hill Golden, M.D. in an article on Hospice news: (“[The rates of pandemic infections and deaths] highlight the social and health inequities in a way that it just makes them glaring." For many of us who have worked with these populations, they have been dying at higher rates for heart disease, diabetes, and renal disease for years. But those are the chronic diseases, so people die more slowly, whereas [COVID-19] is an acute infection.”), she added. According to a study by the Association of Health Care Journalists (AHCJ), end-of-life racial and diagnostic differences at hospice facilities may account for the lower ratings black families award hospice care in their communities. 

Underutilization of hospice care facilities correlates with mistrust of the healthcare system by minorities. Research has revealed systematic racial variations in the intensity of care received at hospice facilities. Drawing data from more than 145 thousand Medicare beneficiaries followed until death, in 577 hospice care facilities, a survey revealed that Blacks were more likely than whites to be admitted, visit the emergency department (ED), and disenroll after hospice enrollment. One of the best ways to democratize care at long-term care facilities is via virtual healthcare (telehealth). It involves utilizing electronic hardware and information technology for the delivery and facilitation of health-related services. Telehealth is particularly beneficial to the vast majority of patients (regardless of race, class, or social status) that own mobile or portable devices. 

The Wound Docs: Better Decision Making With Artificial Intelligence

The Wound Docs has developed its own proprietary automatic wound measuring system to measure wounds accurately.  The Wound Docs documentation system is comprehensive and can substantiate the use of advanced biologics. All Wound Docs physicians partnering with the Wound Docs gain access to our robust, proprietary platform.

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