Research Mentor Name

Dr. Amber Comer, PhD, JD

Research Mentor Email Address

Institution / Department

Wayne State University School of Medicine

Document Type

Research Abstract

Research Type


Level of Research




Palliative care is a vital resource for the critically or terminally ill. It has myriad benefits such as improved quality of life, reduced depressive symptoms, and decreased scarce resource utilization. Self-identified Black/African patients, however, are less likely to utilize advanced care directives or engage in hospice/comfort care measures and are more likely to prefer intensive treatment at the end of life. There is no research, however, on how the COVID-19 pandemic may have affected these trends.


A retrospective cohort study of patients who experienced in hospital mortality or in hospital hospice due to COVID-19 between March 2020 – October 2020 was performed within three major hospital systems in two large urban midwestern cities. Data on patient demographics and clinical characteristics, medical treatments received, and outcomes associated with having a palliative care consultation were collected. Bivariate analyses were performed to determine significance, followed by multivariate analysis on variables with a p<0.10.


A total of n=479 patients were studied, 364 identified as Black/African American, 115 as White. Black patients were less likely to receive a palliative care consult (p<0.028, and more likely to undergo cardiopulmonary resuscitation (p<0.0001), intubation (p<0.0307), and acute/chronic dialysis (p<0.0012). There was no difference between the duration of hospitalization or rate of ICU admission.


Pre-pandemic data shows that there are established differences in the utilization of palliative services among different racial/ethnic groups. Our study found that this persisted throughout the pandemic. This data provides insight into how the pandemic influenced decision-making and may inform future palliative and critical care practices in future global emergencies.


Bioethics and Medical Ethics | Critical Care | Medical Humanities | Medicine and Health Sciences | Palliative Care | Social Justice