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Racial differences in location before hospice enrollment and association with hospice length of stay

TitleRacial differences in location before hospice enrollment and association with hospice length of stay
Publication TypeJournal Article
Year of Publication2011
AuthorsJohnson, KS, Kuchibhatla, M, Tulsky, JA
JournalJ Am Geriatr SocJ Am Geriatr Soc
Date PublishedApr
ISBN Number1532-5415 (Electronic)<br/>0002-8614 (Linking)
Accession Number21410443
KeywordsAfrican Americans, Aged, European Continental Ancestry Group, Female, Hospice Care/ organization & administration, Hospitalization/ statistics & numerical data, Humans, Male, Terminally Ill/ statistics & numerical data, United States
AbstractAfrican Americans are less likely than Whites to enroll in hospice. In addition, patients are often referred to hospice very close to death, when they may not have time to take advantage of the full range of hospice services. Understanding how race and location before hospice enrollment are related to hospice length of stay (LOS) may inform the development of interventions to increase timely access to hospice care. Using data from a national hospice provider, African Americans and Whites admitted to routine home hospice care in a private residence between January 1, 2000, and December 31, 2003, were identified. Logistic regression was used to examine the association between race and hospice preadmission location (hospital vs other locations) and preadmission location and hospice LOS (=7 days vs >7 days) after adjusting for demographic and hospice use variables. Of 43,869 enrollees, 15.3% were African American. One to 2 days before hospice enrollment, African Americans were more likely than Whites to be in the hospital than in all other locations (48.6% vs 32.3%, P<.001 adjusted="" odds="" ratio="1.83," confidence="" interval="1.73-1.95)." regardless="" of="" race="" those="" whose="" preadmission="" location="" was="" the="" hospital="" were="" more="" likely="" than="" from="" other="" locations="" to="" die="" days="" or="" less="" after="" hospice="" enrollment.="" initiatives="" improve="" end-of-life="" care="" should="" focus="" on="" increasing="" timely="" access="" referrals="" in="" settings="" outside="" hospital.="" future="" research="" examine="" whether="" racial="" differences="" reflect="" preferences="" for="" disparities="" non-acute="" settings.="">
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