Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #112799

Kyusuk Chung, PhD, Division of Health Administration and Human Services, Governors State University, F Wing, College of Health Professions, Governors State University, University Park, IL 60466, (708)534-4047, k-chung@govst.edu

A recent study found racial disparity in duration of hospice use between minorities and whites taken care of by paid caregivers, but not when taken care of by their relatives/ unpaid caregivers. Because those with paid caregivers tend to stay in inpatient settings such as nursing homes, it is unclear whether living arrangements or types of caregiver is a factor behind this racial disparity. To clarify this issue, we added one binary variable (inpatient versus all other living arrangements) to the Cox proportional hazard model of the risk of dying within one month after admission to hospice, based on a national representative sample over the age of 65 who died or were discharged alive (N=3,142) from National Home and Hospice Care Survey (pooled data for 1998-2000). As expected, patients in inpatient settings were more likely to die within one month, but this was only true for the non-Hispanic white elderly, not for the minority elderly. Most importantly, adding the living arrangement factor to the model did not alter the finding of a significant race-caregiver interaction effect: Minorities with paid caregivers were two times more likely than non-Hispanic whites with paid caregivers to die within one month (hazard ratio=2.17), whereas this racial disparity was not found when both groups were taken care of by their relatives/ unpaid caregivers (hazard ratio=1.02). This finding corroborates the call for further study: why are elderly minority hospice patients more susceptible as a group than non-Hispanic whites when they both have to rely on paid caregivers?

Learning Objectives:

• Identify factors that affect the delay in receiving hospice care.
• Determine factors affecting receipt of hospice care differently, depending on the types of caregivers.
• Learn the importance of supporting family caregivers, particularly for the minority elderly.

Keywords: End-of-Life Care, Health Disparities

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation