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African American bereaved family members' perceptions of hospice quality: do hospices with high proportions of African Americans do better?

TitleAfrican American bereaved family members' perceptions of hospice quality: do hospices with high proportions of African Americans do better?
Publication TypeJournal Article
Year of Publication2012
AuthorsRhodes, RL, Xuan, L, Halm, EA
JournalJ Palliat MedJ Palliat Med
Volume15
Pagination1137-41
Date PublishedOct
ISBN Number1557-7740 (Electronic)<br/>1557-7740 (Linking)
Accession Number22957678
KeywordsAdult, African Americans/ psychology, Aged, Bereavement, Data Collection, Delivery of Health Care, Family/ ethnology, Female, Health Knowledge, Attitudes, Practice, Hospices, Humans, Male, Middle Aged, Regression Analysis, Terminal Care, United States, Young Adult
AbstractBACKGROUND: Research suggests that racial differences in end-of-life care persist even among patients enrolled in hospice. OBJECTIVE: The objective of the study was to examine the association between bereaved family members' satisfaction with hospice services and the proportion of African American (AA) patients in hospice. METHODS: The 2007 and 2008 Family Evaluation of Hospice Care (FEHC) Survey examined family members' perceptions of the quality of care on several dimensions including: unmet need for pain, dyspnea, and emotional support; being informed about the patient's condition and what to expect as the patient was dying; being informed about medications and treatments for symptoms; coordination of care; and overall satisfaction with care. We examined the association between family members' perception along each domain and the proportion of AAs served by hospices surveyed. RESULTS: Of the 11,892 AA decedents in 678 hospice programs, 53.7% were female. The leading cause of death was cancer (51.6%). On univariate analysis, family members of decedents who died in hospices that had higher proportions of AAs were less likely to have concerns about unmet pain needs (odds ratio [OR] 0.84, 95% confidence interval [CI] 0.72-0.98), more likely to have concerns about coordination of care (1.28, 1.17-1.40), and less likely to perceive care as excellent or very good (0.73, 0.63-0.84). Coordination-of-care concerns and lower overall rating of care persisted in multivariable analyses. There were no other significant associations between family perceptions and proportions of AAs in hospice. CONCLUSIONS: Among hospices with higher proportions of AAs, family members have more concerns about coordination of care and have lower overall perceptions of quality.
Ethno Med: