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Are Hospice Admission Practices Associated With Hospice Enrollment for Older African Americans and Whites?

Publication ,  Journal Article
Johnson, KS; Payne, R; Kuchibhatla, MN; Tulsky, JA
Published in: J Pain Symptom Manage
April 2016

CONTEXT: Hospices that enroll patients receiving expensive palliative therapies may serve more African Americans because of their greater preferences for aggressive end-of-life care. OBJECTIVES: Examine the association between hospices' admission practices and enrollment of African Americans and whites. METHODS: This was a cross-sectional study of 61 North and South Carolina hospices. We developed a hospice admission practices scale; higher scores indicate less restrictive practices, that is, greater frequency with which hospices admitted those receiving chemotherapy, inotropes, and so forth. In separate multivariate analyses for each racial group, we examined the relationship between the proportion of decedents (age ≥ 65) served by a hospice in their service area (2008 Medicare Data) and admission practices while controlling for health care resources (e.g., hospital beds) and market concentration in the area, ownership, and budget. RESULTS: Nonprofit hospices and those with larger budgets reported less restrictive admission practices. In bivariate analyses, hospices with less restrictive admission practices served a larger proportion of patients in both racial groups (P < 0.001). However, in the multivariate models, nonprofit ownership and larger budgets but not admission practices predicted the outcome. CONCLUSION: Hospices with larger budgets served a greater proportion of African Americans and whites in their service area. Although larger hospices reported less restrictive admission practices, they also may have provided other services that may be important to patients regardless of race, such as more in-home support or assistance with nonmedical expenses, and participated in more outreach activities increasing their visibility and referral base. Future research should explore factors that influence decisions about hospice enrollment among racially diverse older adults.

Duke Scholars

Published In

J Pain Symptom Manage

DOI

EISSN

1873-6513

Publication Date

April 2016

Volume

51

Issue

4

Start / End Page

697 / 705

Location

United States

Related Subject Headings

  • White People
  • Urban Population
  • South Carolina
  • Rural Population
  • North Carolina
  • Multivariate Analysis
  • Humans
  • Hospitalization
  • Hospices
  • Hospice Care
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Johnson, K. S., Payne, R., Kuchibhatla, M. N., & Tulsky, J. A. (2016). Are Hospice Admission Practices Associated With Hospice Enrollment for Older African Americans and Whites? J Pain Symptom Manage, 51(4), 697–705. https://doi.org/10.1016/j.jpainsymman.2015.11.010
Johnson, Kimberly S., Richard Payne, Maragatha N. Kuchibhatla, and James A. Tulsky. “Are Hospice Admission Practices Associated With Hospice Enrollment for Older African Americans and Whites?J Pain Symptom Manage 51, no. 4 (April 2016): 697–705. https://doi.org/10.1016/j.jpainsymman.2015.11.010.
Johnson KS, Payne R, Kuchibhatla MN, Tulsky JA. Are Hospice Admission Practices Associated With Hospice Enrollment for Older African Americans and Whites? J Pain Symptom Manage. 2016 Apr;51(4):697–705.
Johnson, Kimberly S., et al. “Are Hospice Admission Practices Associated With Hospice Enrollment for Older African Americans and Whites?J Pain Symptom Manage, vol. 51, no. 4, Apr. 2016, pp. 697–705. Pubmed, doi:10.1016/j.jpainsymman.2015.11.010.
Johnson KS, Payne R, Kuchibhatla MN, Tulsky JA. Are Hospice Admission Practices Associated With Hospice Enrollment for Older African Americans and Whites? J Pain Symptom Manage. 2016 Apr;51(4):697–705.
Journal cover image

Published In

J Pain Symptom Manage

DOI

EISSN

1873-6513

Publication Date

April 2016

Volume

51

Issue

4

Start / End Page

697 / 705

Location

United States

Related Subject Headings

  • White People
  • Urban Population
  • South Carolina
  • Rural Population
  • North Carolina
  • Multivariate Analysis
  • Humans
  • Hospitalization
  • Hospices
  • Hospice Care