Objective: To examine whether regional practice patterns impact racial/ethnic differences in intensity of end-of-life care for cancer decedents.
Data sources: The linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database.
Study design: We classified hospital referral regions (HRRs) based on mean 6-month end-of-life care expenditures, which represented regional practice patterns. Using hierarchical generalized linear models, we examined racial/ethnic differences in the intensity of end-of-life care across levels of HRR expenditures.
Principal findings: There was greater variation in intensity of end-of-life care among Hispanics, Asians, and whites in high-expenditure HRRs than in low-expenditure HRRs.
Conclusions: Local practice patterns may influence racial/ethnic differences in end-of-life care.
Keywords: Racial differences; end-of-life care; geographic variation; regional practice patterns.
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