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Dying minority elderly and hospice care: Types of caregiving

Kyusuk Chung, PhD1, Duck-Hye Yang, PhD2, and Ralph Bell, PhD1. (1) Department of Health Administration, College of Health Professions, Governors State University, 1 University Parkway, University Park, IL 60466, (708)534-4047, k-chung@govst.edu, (2) Chapin Hall Center for Children, University of Chicago, 1313 E. 60th street, Chicago, IL 60637

Amid concerns that hospice referrals are occurring too late for many patients to fully benefit from hospice care, we compared the probability of receiving hospice care for less than 30 days (hereafter, short stay) between non-Hispanic whites and minorities. We used a sample of discharges from hospice care (N=2,906) pooled from the 1998 and 2000 National Home and Hospice Care Survey whose age at the discharge was 65 or older; and who died while in hospice care. A logistic regression model was estimated to determine the probability of a short stay, controlling for type of caregiving (formal caregiving defined as paid aid/staff from a facility where a patient resides, having no caregiver, and informal caregiving by family/relatives/friends), medical diagnoses, age, sex, and survey year. Separate coefficients were estimated for non-Hispanic whites and minorities group to examine the differential effect of caregiving type. Our findings show that, controlling for all other variables, minority patients are more likely to stay short term than non-Hispanic whites (OR: 1.22, CI: 1.05 – 1.45, p=.02). The source of this disparity appears to be in the quality of formal caregiving for minorities as opposed to non-Hispanic whites: For minorities, there was a large, significant difference between formal and informal caregiving (OR: 4.67,CI: 2.45 – 9.46, p<.0001), but there was no difference for non-Hispanic whites (OR: 1.0, p=.88). Further study is needed to examine various aspects of formal caregiving received by minorities as opposed to the formal caregiving received by non-Hispanic whites in an attempt to account for these differences.

Learning Objectives:

Keywords: Minority Health, End-of-Life Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Planning for and Caring during the End of Life

The 132nd Annual Meeting (November 6-10, 2004) of APHA