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

J Gen Intern Med. 2007 Mar;22(3):396-9. doi: 10.1007/s11606-006-0034-y.

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.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • African Americans
  • Aged
  • Aged, 80 and over
  • European Continental Ancestry Group
  • Female
  • Hispanic Americans
  • Hospice Care
  • Hospices / statistics & numerical data*
  • Humans
  • Male
  • Minority Groups*
  • Neoplasms / epidemiology*
  • Neoplasms / therapy
  • Retrospective Studies
  • Terminally Ill