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J Gen Intern Med. 2007 Mar;22(3):396-9.

Lower use of hospice by cancer patients who live in minority versus white areas.

Author information

1
Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02120-1613, USA. jhaas@partners.org

Abstract

BACKGROUND:

Although hospice care can alleviate suffering at the end of life for patients with cancer, it remains underutilized, particularly by African Americans and Hispanics.

OBJECTIVE:

To examine whether the racial composition of the census tract where an individual resides is associated with hospice use.

DESIGN:

Retrospective analysis of the Surveillance, Epidemiology, and End Results-Medicare file for individuals dying from breast, colorectal, lung, or prostate cancer (n = 70,669).

MEASUREMENTS:

Hospice use during the 12 months before death.

RESULTS:

Hospice was most commonly used by individuals who lived in areas with fewer African-American and Hispanic residents (47%), and was least commonly used by individuals who lived in areas with a high percentage of African-American and Hispanic residents (35%). Hispanics (odds ratio 0.51, 95% confidence interval 0.29-0.91) and African Americans (0.56, 0.44-0.71) were less likely to use hospice if they lived in a census tract with a high percentage of both African Americans and Hispanics than if they lived in a low minority tract. African Americans and whites were less likely to receive hospice care if they lived in a census tract with a high percentage of Hispanics than if they lived in a low minority area.

CONCLUSIONS:

Increasing hospice use may require interventions to improve the delivery of hospice care in minority communities.

PMID:
17356975
PMCID:
PMC1824733
DOI:
10.1007/s11606-006-0034-y
[Indexed for MEDLINE]
Free PMC Article
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