+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Racial differences in hospice use and in-hospital death among Medicare and Medicaid dual-eligible nursing home residents



Racial differences in hospice use and in-hospital death among Medicare and Medicaid dual-eligible nursing home residents



Gerontologist 48(1): 32-41



We investigated the role of race in predicting the likelihood of using hospice and dying in a hosptial among dual-eligible (Medicare and Medicaid) nursing home residents. This follow-back cohort study examined factors associated with hospice use and in-hospital death among non-Hispanic Black and non-Hispanic White dual-eligible nursing home residents (N = 30,765) who died in Florida during one of three years: 2000, 2001, or 2002. We used logistic regression models to identify independent predictors of hospice use and in-hospital death. After we controlled for other factors, Black residents were significantly less likely to use hospice and more likely to die in a hospital. Principal cause of death moderated the relationship between race and hospice use: Black residents were significantly less likely to use hospice than White residents among residents without cancer as principal cause of death, but there was no difference among residents with cancer as cause of death. Further analyses for each racial group revealed that the impact of cause of death in predicting hospice use was greater among Black residents than White residents. Hospice care offers many benefits, including reduced risk of in-hospital death, but Black nursing home residents are less likely to use hospice and may have different perceptions of need for hospice care compared with White residents. Future research and outreach efforts should focus on developing culturally sensitive, disease-focused end-of-life education and communication interventions that target residents, families, nursing home providers, and physicians.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 055341186

Download citation: RISBibTeXText

PMID: 18381830

DOI: 10.1093/geront/48.1.32


Related references

Racial Differences in Hospitalizations of Dying Medicare-Medicaid Dually Eligible Nursing Home Residents. Journal of the American Geriatrics Society 64(9): 1798-1805, 2017

Racial disparities in in-hospital death and hospice use among nursing home residents at the end of life. Medical Care 49(11): 992-998, 2011

Racial differences in switching, augmentation, and titration of lipid-lowering agents by Medicare/Medicaid dual-eligible patients. American Journal of Managed Care 13 Suppl 3(): S72-S79, 2007

Medicare Part D plan generosity and medication use among dual-eligible nursing home residents. Medical Care 51(10): 894-900, 2013

The influence of hospice use on nursing home and hospital use in assisted living among dual-eligible enrollees. Journal of the American Medical Directors Association 13(2): 189.E9-189.E13, 2012

Examining differences in death rates for medicaid and non-medicaid nursing home residents. Medical Care 42(10): 985-991, 2004

Site of death in the hospital versus nursing home of Medicare skilled nursing facility residents admitted under Medicare's Part A Benefit. Journal of the American Geriatrics Society 52(8): 1247-1254, 2004

Risk of death in dual-eligible nursing home residents using typical or atypical antipsychotic agents. Medical Care 50(11): 961-969, 2013

Effect of long-term care use on Medicare and Medicaid expenditures for dual eligible and non-dual eligible elderly beneficiaries. Medicare & Medicaid Research Review 3(3): -, 2015

The effect of Medicaid nursing home reimbursement policy on Medicare hospice use in nursing homes. Medical Care 49(9): 797-802, 2011

Neuropsychiatric symptom patterns in hospice-eligible nursing home residents with advanced dementia. Journal of the American Medical Directors Association 9(7): 509-515, 2008

Racial disparities in receipt of hospice services among nursing home residents. American Journal of Hospice & Palliative Care 32(2): 233-237, 2016

Antipsychotics and the Risks of Sudden Cardiac Death and All-Cause Death: Cohort Studies in Medicaid and Dually-Eligible Medicaid-Medicare Beneficiaries of Five States. Journal of Clinical & Experimental Cardiology Suppl 10(6): 1-9, 2013

Influence of hospice on nursing home residents with advanced dementia who received Medicare-skilled nursing facility care near the end of life. Journal of the American Geriatrics Society 60(11): 2035-2041, 2013

Potentially avoidable hospitalizations of dually eligible Medicare and Medicaid beneficiaries from nursing facility and Home- and Community-Based Services waiver programs. Journal of the American Geriatrics Society 60(5): 821-829, 2012