Hospice Use by Hispanic and non-Hispanic White Cancer Decedents

Health Serv Res. 2004 Aug;39(4 Pt 1):969-83. doi: 10.1111/j.1475-6773.2004.00267.x.


Objective: To investigate rates of hospice use between Hispanic and non-Hispanic white Medicare beneficiaries diagnosed with cancer using data from a large, population-based study.

Data sources: Secondary data from the linked SEER-Medicare database including the SEER areas of Los Angeles, San Francisco, and San Jose-Monterey, California, and the state of New Mexico. All subjects were Hispanic or non-Hispanic whites, aged 67 and older, had a cancer diagnosis of breast, colorectal, lung, or prostate cancer from 1991-1996, and died of cancer from 1991-1998.

Study design: This study employed a retrospective cohort design to compare rates of hospice use between Hispanics and non-Hispanic whites across patient characteristics and over time.

Principal findings: Rates of hospice use were similar for Hispanics (39.2 percent) and non-Hispanic whites (41.5 percent). In a bivariate logistic regression model, Hispanics were significantly less likely to use hospice than non-Hispanic whites (OR 0.91; 95 percent CI 0.85-0.97). However, after adjusting for age, marital status, sex, educational attainment, income, urban versus rural residence, and type of insurance using multivariate logistic regression analysis, the estimated odds for being a hospice user among Hispanics is similar to the odds of being a hospice user among non-Hispanic whites (OR 1.05; 95 percent CI 0.98-1.13). Stratified analyses revealed significant differences between ethnic groups in the use of hospice by type of insurance and SEER area, indicating interactions between ethnicity and these variables.

Conclusions: Our findings indicate similar rates of hospice use for Hispanics and non-Hispanic whites diagnosed with one of the four leading cancers. Additional studies from other national registries may be necessary to confirm these findings.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / therapy
  • California / epidemiology
  • Cohort Studies
  • Colorectal Neoplasms / therapy
  • Cultural Characteristics
  • European Continental Ancestry Group / statistics & numerical data*
  • Female
  • Hispanic Americans / statistics & numerical data*
  • Hospice Care / statistics & numerical data*
  • Humans
  • Lung Neoplasms / therapy
  • Male
  • Multivariate Analysis
  • Neoplasms / ethnology*
  • Neoplasms / therapy*
  • New Mexico / epidemiology
  • Odds Ratio
  • Patient Acceptance of Health Care / ethnology*
  • Prostatic Neoplasms / therapy
  • Retrospective Studies
  • SEER Program